Joel Philip Carpenter, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26790 Issued in TN

Practice address

1605 Roberta Dr SW
Marietta, GA 30008-3855

Phone

(770) 419-3120

Fax

(770) 419-3121

NPI assigned

Oct 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Loyola University of Chicago, Stritch School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Health Center of CobbGroup PAC ID 7214970482, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Good Samaritan Health Center of Cobb

  • Federally Qualified Health Center (FQHC)
  • Marietta, GA
  • NPI 1881923126
  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Family Medicine

  Medicare reassignment NPD
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1912458456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DRIVE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30008",
            "telephone_number": "770-419-3120",
            "fax_number": "770-419-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120",
            "fax_number": "770-419-3121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 N 2nd St",
            "address_purpose": "LOCATION",
            "city": "Rochelle",
            "state": "IL",
            "postal_code": "610681764",
            "country_code": "US",
            "telephone_number": "815-562-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JOEL",
        "middle_name": "PHILIP",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 59150",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "77437",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "26790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1175 Cascade Pkwy SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303113090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Viktoriya Petrovna Carney
• Carol Nemerov Otr/L
• Roxanne Caron, DC
• David James Carpenter, MD, MHSC
• Elizabeth Carpenter, PHARM.D
• Matthew D Carpenter, AAC
• Samantha Carpenter, FNP-C
• Carpus Surgery Center LLC
• Rena Marie Carr, AGACNP-BC
• Dominic S Carreira, M.D.

• Family Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.