Physician Compare National (NPI:1376600486)

HEALTHCARE PROVIDER: RICHARD LEE CARPENTER JR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1376600486
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698753846
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071219000234
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CARPENTER
	Individual professional last name
Provider First Name	RICHARD
	Individual professional first name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2734 CLEVELAND ST
	Group Practice or individual's line 1 address
City	ELLOREE
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	290479538
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8038972128
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRMC OF ORANGEBURG & CALHOUN
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	420073
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LEXINGTON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	420079
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TRIDENT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y