Individual provider Active NPI

Mary Ellen Carpenter, CNM, FNP

  • Family Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1699984203
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
000030956N1 Issued in OR
Practice address
1902 Jefferson St
Suite 2
Eugene, OR 97405-2414
Phone
(541) 284-8882
Fax
(541) 284-2826
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 000030956N1 OR Primary

Addresses

Primary practice location

1902 Jefferson St
Suite 2
Eugene, OR 97405-2414

Mailing address

PO Box 70368
Suite 2
Springfield, OR 97475-0120
Phone (541) 349-7600

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
000030956N1ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Physical Therapy, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17276/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1699984203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70368",
            "address_2": "SUITE 2",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750120",
            "telephone_number": "541-349-7600",
            "fax_number": "541-686-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052414",
            "telephone_number": "541-284-8882",
            "fax_number": "541-284-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "CNM, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "000030956N1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.