DR. DOUGLAS RAY CARPENTER JR. MD
NPI 1093818635
Family Medicine in Crossville, TN

Active since September 07, 2006PECOS EnrolledAccepts Medicare Assignment
100 LANTANA ROAD, SUITE 202, CROSSVILLE, TN 38555(931) 484-5141(931) 484-5620 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Douglas Ray Carpenter Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS RAY CARPENTER JR. MD (NPI 1093818635) is an individual family medicine provider in Crossville, Tennessee, licensed in Tennessee (MD17544) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Cumberland Medical Center, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1985).

NPPES Registry Identity

NPI1093818635
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DOUGLAS RAY CARPENTER JR.Credential: MD
Location Address100 LANTANA ROAD, SUITE 202Crossville, TN 38555-1903
Mailing Address100 Lantana Road, Suite 202Crossville, TN 38555-1903 · (931) 484-5141 · Fax (931) 484-5620
Fax(931) 484-5620
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1985
Enumeration DateSeptember 7, 2006
Last NPPES UpdateJune 7, 2021
NPPES CertifiedJune 7, 2021
NPI 1093818635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TN · MD17544
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

100 LANTANA ROAD, Crossville, TN 38555

Other Identifiers 3

Medicaid3084713TN
Other3072543TN · Blue Cross
Other080059056Railroad Medicare

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Douglas Ray Carpenter Jr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749379493
PECOS Enrollment IDI20091201000005
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 25

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
271 services139 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
239 services152 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
225 services112 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
202 services147 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
202 services149 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
169 services132 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cumberland Medical Center

Acute Care Hospitals · Crossville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440009
Location421 S Main StCrossville, TN 38555 · Cumberland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38555 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
76%5,920 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
18%480 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%293 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
93%1,523 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
56%1,536 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%1,536 patients1/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers37 claims75 services$5.69 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers20 claims24 services$0.85 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers13 claims13 services$40.94 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers20 claims20 services$113.38 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers21 claims54 services$42.70 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers21 claims126 services$2.79 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
100 LANTANA ROAD, SUITE 202
CROSSVILLE, TN 38555
Internal Medicine
100 LANTANA ROAD, SUITE 202
CROSSVILLE, TN 38555
Internal Medicine
100 LANTANA ROAD, SUITE 202
CROSSVILLE, TN 38555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Carpenter's NPI number?

The NPI number for Douglas Carpenter is 1093818635. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Douglas Carpenter located?

Douglas Carpenter practices at 100 Lantana Road Suite 202, Crossville, TN 38555. The listed phone number is (931) 484-5141.

What is Douglas Carpenter's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Carpenter enrolled in Medicare?

Yes. Douglas Carpenter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Carpenter accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Douglas Carpenter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Carpenter affiliated with any hospitals?

According to CMS data, Douglas Carpenter is affiliated with Cumberland Medical Center.

When was this NPI record last updated?

The NPPES record for Douglas Carpenter was last updated on June 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.