Individual provider Active NPI

Robert Paul Carpenter, CRNA

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
National Provider Identifier
1417036419
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
19619 Issued in TN
Practice address
2301 South Lamar Blvd.
Oxford, MS 38655
Phone
(662) 232-8100
Fax
(334) 244-1830
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R852840 MS
Certified Registered Nurse Anesthetist 367500000X 19619 TN Primary

Addresses

Primary practice location

2301 South Lamar Blvd.
Oxford, MS 38655

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000589 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810953957 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians
State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, shared by 23 NPIs, 956 clinicians

Practice addresses (Care Compare)

2100 Exeter Rd
Suite 200
Germantown, TN 38138-3966
Phone (901) 699-4436

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
19619TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Pain and Wellness, LLC CurrentSince Sep 1, 2020 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Aug 2, 2025 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2013 Accepting new patients
Willow Pain and Wellness, LLC CurrentSince Sep 1, 2020 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Aug 27, 2024 Accepting new patients
Axis Anesthesia Nurse Anesthetist, Certified Registered Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince May 1, 2019 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
Tupelo Anesthesia Group PA Past Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
#4200
Jackson, MS 39216

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

2301 S Lamar Blvd
Oxford, MS 38655
Phone (662) 232-8369

2215 Jefferson Davis Dr
Oxford, MS 38655
Phone (662) 234-3303

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

Interoperability endpoints

  • Direct secure messaging: ksnyder67547@ummc.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1417036419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2053",
            "fax_number": "334-244-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SOUTH LAMAR BLVD.",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-232-8100",
            "fax_number": "334-244-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R852840",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "19619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.