Mark Merritt Carpenter, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9843 Issued in AL

Practice address

101 Bob Wallace Ave SW
Huntsville, AL 35801-3843

Phone

(256) 533-0335

Fax

(256) 539-9880

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982685236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE",
            "address_2": "STE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-535-5940",
            "fax_number": "256-535-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013843",
            "telephone_number": "256-533-0335",
            "fax_number": "256-539-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MARK",
        "middle_name": "MERRITT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "9843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51051905",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA IDENTIFICATION NO",
            "identifier": "0004003511",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051905",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justine Clarissa Carlisle, CERTIFIED HAIR LOSS
• Preston Carlson, ATC
• Carlton Cove Inc.
• Connie Rae Carnes, M.S.
• Emily Klae Carnes, PA-C
• Tatia Lynn Carpenter, RPH
• Gail L Carr, CRNA
• James Raymond Carr
• Kara Carr, CRNP
• Lisa Isabell Carr

• Surgery Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.