NPIMap

Individual provider Active NPI

Samuel R Carter III, MD

  • Internal Medicine Physician
  • Joplin, MO
National Provider Identifier
1760428973
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
109788 Issued in 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
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 109788 MO Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000205 MO Practitioner - Internal Medicine 5496843120 Receives reassigned benefits from 2 practitioners
Practice locations: Joplin, MO

Care Compare profile

Medicare Care Compare
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109788MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel R Carter, M.D. Internal Medicine PastSince Mar 1, 2009 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1760428973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 S MAIDEN LN STE 203",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040319",
            "telephone_number": "417-659-4661",
            "fax_number": "417-659-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S MAIDEN LN STE 203",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040319",
            "telephone_number": "417-659-4661",
            "fax_number": "417-659-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "109788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.