Healthcare Provider Details

I. General information

NPI: 1023841244
Provider Name (Legal Business Name): CARPENTER MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 MAZZINI ST
ERIE CO
80516-2491
US

IV. Provider business mailing address

458 MAZZINI ST
ERIE CO
80516-2491
US

V. Phone/Fax

Practice location:
  • Phone: 719-398-1901
  • Fax:
Mailing address:
  • Phone: 281-415-8837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL MARINCH CARPENTER
Title or Position: FOUNDER, CEO
Credential: MD FAAFP
Phone: 719-398-1901