LARRY RENN CARPENTER (NPI# 1912982901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912982901 |
| Entity Type | Individual |
| Full Name | LARRY RENN CARPENTER |
| Credential | PA-C |
| Practice Address |
100 3rd St Ste 1 Davenport WA 99122-5008 |
| Practice Telephone | 5097257501 |
| Practice Fax Number | 5097257501 |
| Mailing Telephone | 5097257501 |
| Mailing Fax Number | 5097257501 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2020-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA60136165 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2005809 | 05 | |
| WA | WASHINGTON STATE DEPT OF LABOR & INDUSTRIES | 295800 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929518 | Larry Steven Carpenter | Radiology | 2491 S Braeswood Blvd, Houston, TX 77030-4332 | 2005-08-22 |
| Street Address |
100 3RD ST STE 1 |
| City | DAVENPORT |
| State | WA |
| Zip Code | 99122-5008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265917140 | Virginia Hawthorne | Nurse Practitioner | 100 3rd St Ste 1, Davenport, WA 99122-5008 | 2018-09-26 |
| 1578011789 | Tyler W. Zaugg | Physician Assistant | 100 3rd St Ste 1, Davenport, WA 99122-5008 | 2016-09-16 |
| 1053527853 | Lincoln County Hospital District 3 | Surgery | 100 3rd St Ste 1, Davenport, WA 99122-5008 | 2007-05-16 |
| 1720028244 | Chad A Mongrain | Family Medicine | 100 3rd St Ste 1, Davenport, WA 99122-5008 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003387697 | Creekside Pharmacy LLC | Pharmacy | 639 Morgan Street, Davenport, WA 99122 | 2018-12-08 |
| 1366959470 | Kandis Rose Paskell | Counselor | 547 Morgan Street, Davenport, WA 99122 | 2018-01-10 |
| 1538567839 | Alyssa Fleming | Speech-Language Pathologist | 28000 Prairie Springs Drive, Davenport, WA 99122 | 2014-12-18 |
| 1477742500 | Daniel W Pitman | Counselor | 1102 8th Street, Davenport, WA 99122 | 2007-10-15 |
| 1730201856 | Capstone Behavioral Health | Counselor | 49 Park Street, Davenport, WA 99122 | 2007-04-06 |
| 1972625762 | David Lee Turner | Dentist | 707 Logan St, Davenport, WA 99122 | 2007-04-04 |
| 1982723318 | Dawn Lorraine Wilcox | Counselor | 49 Park, Unit C, Davenport, WA 99122 | 2007-03-28 |
| 1184789703 | Michael G Van Pevenage | Physical Therapist | 506 Morgan Street, Davenport, WA 99122 | 2006-12-26 |
| 1447323811 | Davenport Vision Clinic, Inc. | Optometrist | 506 8th St, Davenport, WA 99122 | 2006-11-15 |
| 1912002791 | Davenport Pharmacy Inc | Pharmacy | 525 Morgan St, Davenport, WA 99122 | 2006-09-14 |
| Find all providers in zip 99122 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
| 1861008443 | Justyna Wojtyczka | Physician Assistant | 518 W Locust St, Davenport, IA 52803-2829 | 2020-09-19 |
| 1962891499 | Kristian Delanie Williams | Physician Assistant | 40124 Highway 27, Suite 104, Davenport, FL 33837-5905 | 2015-01-21 |
| 1457696080 | Karyl Hobbs | Physician Assistant | 2502 Sand Mine Rd, Davenport, FL 33897-3402 | 2012-12-07 |
| 1992094049 | Davenport Medical Center LLC | Physician Assistant | 203 N Broadway, Davenport, OK 74026 | 2011-03-29 |
| 1699913061 | Nicole Marie Luszczyk | Physician Assistant | 2322 E Kimberly Rd, Ste 100n, Davenport, IA 52807-7205 | 2009-01-23 |
| 1790742864 | Jeremy J Mcgrath | Physician Assistant | 3385 Dexter Ct, Ste 101, Davenport, IA 52807-3471 | 2006-05-01 |
| 1477528073 | Paulette Ong | Physician Assistant | 1801 E 54th St, Ste 100, Davenport, IA 52807-7209 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.