Dustin Ross Carlisle, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

232197 Issued in LA

Practice address

1811 E Bert Kouns Industrial Loop Ste 210
Shreveport, LA 71105-5740

Phone

(318) 212-3858

Fax

(318) 212-3958

NPI assigned

Apr 9, 2024

Last updated

Nov 5, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Pierremont CardiologyGroup PAC ID 0547571499, 27 clinicians

Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• WK Pierremont Cardiology

  • Cardiovascular Disease Physician
  • Shreveport, LA
  • NPI 1235523002
  Medicare reassignment Care Compare group NPD
• Cross Lake Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1013497114
  Medicare reassignment Care Compare group
• Northwest Louisiana Nephrology, LLC

  • Nephrology Physician
  • Shreveport, LA
  • NPI 1669416491
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1083467104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3858",
            "fax_number": "318-212-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3858",
            "fax_number": "318-212-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "DUSTIN",
        "middle_name": "ROSS",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "232197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caring Compassion Counsesling LLC
• Caring Hands Pediatric Day Health Center, LLC
• Caring Hearts Transportation LLC
• James Carinio Jr., CIT
• Charles Richard Carleton, MSN, FNP-C
• Kelly Morgan Carlisle, M.D.
• Lane S Carlisle, NP
• Wesley D. Carlisle, MD, DMD
• Harry Carmack
• Carmichael's Cashway Pharmacy, Inc. (Carmichael's North)

• Family Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.