Charles Keith Carpenter, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704271364 Issued in MI

Practice address

4000 Wellness Dr
Midland, MI 48670-2483

Phone

(844) 832-1956

NPI assigned

Jan 6, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Michigan Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mymichigan Medical Group

  • Family Medicine Physician
  • Midland, MI
  • NPI 1740230127

  MI

  Medicare reassignment Care Compare group NPD
• Sound Inpatient Physicians-Michigan, PLLC

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1093967861

  MI, Nurse Practitioner

  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  • Rural Health Clinic/Center
  • Alpena, MI
  • NPI 1144722604
  Care Compare group NPD
• Mymichigan Medical Group

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1689623506
  Care Compare group
• Mymichigan Medical Group

  • Pediatrics Physician
  • Midland, MI
  • NPI 1912957390
  Care Compare group
• Mymichigan Medical Group

  • Internal Medicine Physician
  • Midland, MI
  • NPI 1629027669
  NPD
• Sound Inpatient Physicians - Michigan, PLLC

  • Hospitalist Physician
  • Escanaba, MI
  • NPI 1366768178
  NPD
• Mymichigan Medical Center Saginaw

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1801218680
  NPD (past)
• Mymichigan Medical Center Saginaw

  • Family Medicine Physician
  • Frankenmuth, MI
  • NPI 1912995465
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1497085963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272",
            "telephone_number": "989-797-1400",
            "fax_number": "989-797-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702483",
            "telephone_number": "844-832-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "CHARLES",
        "middle_name": "KEITH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-06",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704271364",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "4704271364",
            "primary": false
        },
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "MI",
            "license": "4704271364",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704271364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlescarpenter@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "9900 Birch Run Rd Ste D",
            "city": "Birch Run",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484159609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caregiving Network, Inc.
• Carelinc Medical Equipment & Supply Co LLC
• Adrianna Carlisle
• Carlos Uribe DDS PLC
• Carol Robinson Ma LPC Counseling Services PLLC
• Samantha Carpenter
• Beccalynne Myriah Carson, PA
• Clancy Alexandrea Carter
• John Lawerence Carter III
• Stefano Carter, DC

• All providers in Midland, MI
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.