Laura Cara Carlisle

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2440 W Marion Ave
Punta Gorda, FL 33950

Phone

(860) 748-3130

NPI assigned

Dec 12, 2017

Last updated

Aug 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Lauracara Carlisle Moffo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1306351424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 W MARION AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339505153",
            "telephone_number": "860-748-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 W MARION AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "33950",
            "telephone_number": "860-748-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4575 SE Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349976826",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "LAURA",
        "middle_name": "CARA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURACARA",
            "last_name": "MOFFO",
            "middle_name": "CARLISLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Randy Dale Casey, PT

• Developmental Therapist in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.