Carpenter Primary Healthcare, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6284 Issued in TN

Legal business name

CARPENTER PRIMARY HEALTHCARE, PLLC

Practice address

1251 Wesley Dr
Suite 104
Memphis, TN 38116-6442

Phone

(901) 348-6426

NPI assigned

Jan 2, 2015

Last updated

Aug 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Andre Carpenter Sr.

Title

Chief Operating Officer

Phone

(901) 463-0105

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Terrell Cheatham Carpenter, FNP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1043364201
  Medicare reassignment NPD
• Raven Johnson Bratcher, DNP, APRN, FNP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1205397809
  Medicare reassignment NPD

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1770971533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WESLEY DR STE 104",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166442",
            "telephone_number": "901-348-6426",
            "fax_number": "901-207-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 WESLEY DR",
            "address_2": "SUITE 104",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166442",
            "telephone_number": "901-348-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARPENTER PRIMARY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ANDRE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "901-463-0105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "6284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Caron, MD
• Eric Caron, MSN, APN
• Joshua Elias Caron, PH.D.
• Felecia L Carothers
• Terra Jeanette Carouthers, MASTER'S PSYCH
• Cassandra Carpenter
• Joseph Carpenter, RPH
• Mary B Carpenter, LCSW CEAP
• Pretia Alonna Carpenter
• Emily Megan Carr

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.