Samuel R Carter III, MD
Individual provider Active NPI Internal Medicine Physician · Joplin, MO
NPI 1760428973 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1760428973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 109788 (MO)
- Practice address
- 2024 S Maiden LN Ste 203
Joplin, MO 64804-0319 - Phone
- (417) 659-4661
- Fax
- (417) 659-8509
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Texas Medical Branch at Galveston, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2024 Maiden Lane
Suite 203
Joplin, MO 64804-0343
2024 S Maiden LN
Suite 203
Joplin, MO 64804-0319
Phone (417) 659-4661
2024 S Maiden LN
Suite 203
Joplin, MO 64804-0343
Hospital & facility affiliations
- Amedisys Home Health of Missouri
- Phoenix Home Care and Hospice
- Freeman Home Care Services
- Freeman Health System - Freeman West
- Mercy Hospital Joplin
- Freeman Neosho Hospital
- Mercy Hospital Carthage
- Mercy Specialty Hospital Southeast Kansas
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071114000205 | MO | Practitioner - Internal Medicine | 5496843120 |
Receives reassigned benefits from 2 practitioners Practice locations: Joplin, MO |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109788 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samuel R Carter, M.D. | Internal Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 109788 | MO | Yes |
Addresses
Primary practice location
2024 S Maiden LN Ste 203
Joplin, MO 64804-0319
Mailing address
2024 S Maiden LN Ste 203
Joplin, MO 64804-0319
Phone (417) 659-4661
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110136988 | Other | RR MEDICARE | |
| 100188880A | Medicaid | KS | |
| 31655 | Other | MO | ANTHEM |
| 100069440A | Medicaid | OK | |
| 208238105 | Medicaid | MO |
Other providers in Joplin, MO
- Rush Linden Carr
- Eric Matthew Carrillo
- Carson Chiropractic LLC
- Hope K Carson
- Carrie Carter
- Kristen Carzoli
- Ashlann Casey
- Chad William Cassady Jr.
- Mireya Castilleja
- Gretchen Gibson Castleman
All providers in Joplin, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.