NPIMap

Individual provider Active NPI

Martin Wallace Carpenter, MD

  • Psychiatry Physician
  • Cedar Rapids, IA
National Provider Identifier
1558359174
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35422 Issued in IA
Practice address
Mercy Medical Center
701 10TH Street SE
Cedar Rapids, IA 52403
Phone
(319) 369-4777
Fax
(319) 369-4694
NPI assigned
Oct 7, 2005
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35422 IA Primary

Addresses

Primary practice location

Mercy Medical Center
701 10TH Street SE
Cedar Rapids, IA 52403

Mailing address

Mercy Medical Center
701 10TH Street SE
Cedar Rapids, IA 52403
Phone (319) 369-4777

Other identifiers 2

IdentifierTypeStateIssuer
36682MedicaidIA
13725OtherIABC PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Missouri, Columbia School of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

1486 S 1St Ave
Suite B
Iowa City, IA 52240-6072

1715 1St Ave SE
Suite 200
Cedar Rapids, IA 52402-5432

8101 Birchwood Court
Suite B
Johnston, WI 50131-2930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35422IAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abbe Center for Community Mental Health, Inc Past Accepting new patients
Trinity Regional Medical Center Past Accepting new patients
Community Mental Health Center for Mid-Eastern Iowa PastSince Mar 23, 1994 Accepting new patients
Optimae Lifeservices, Inc, Past Accepting new patients
Abbe Center for Community Mental Health, Inc Past Accepting new patients
Nurse in the House, Inc. Past Accepting new patients
Mercy Medical Center Past Accepting new patients
Abbe Management Corp PastSince Jul 1, 1994 Accepting new patients

Organizations & group practices 8

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1558359174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MERCY MEDICAL CENTER",
            "address_2": "701 10TH STREET SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-369-4777",
            "fax_number": "319-369-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MERCY MEDICAL CENTER",
            "address_2": "701 10TH STREET SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-369-4777",
            "fax_number": "319-369-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MARTIN",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "35422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36682",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PROVIDER NUMBER",
            "identifier": "13725",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.