Individual provider Active NPI

Richard M Carpenter, DO

  • Family Medicine Physician
  • Federal Way, WA
National Provider Identifier
1427067958
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00000763 Issued in WA
Practice address
30809 1St Ave S
Federal Way, WA 98003-4074
Phone
(253) 839-2030
Fax
(253) 839-1071
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00000763 WA Primary

Addresses

Primary practice location

30809 1St Ave S
Federal Way, WA 98003-4074

Mailing address

30809 1St Ave S
Federal Way, WA 98003-4074
Phone (253) 839-2030

Other identifiers 4

IdentifierTypeStateIssuer
0199176OtherWASTATE L&I
8906588OtherWASTATE CRIME VICTIMS
P00244072OtherWAMEDICARE RAILROAD
1689702MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
763WAMDAcupuncturist
OP00000763WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1427067958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30809 1ST AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034074",
            "telephone_number": "253-839-2030",
            "fax_number": "253-839-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30809 1ST AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034074",
            "telephone_number": "253-839-2030",
            "fax_number": "253-839-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00000763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0199176",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8906588",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00244072",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689702",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.