NPIMap

Individual provider Active NPI

Kevin Carlisle, MD

  • Family Medicine Physician
  • Rayville, LA
National Provider Identifier
1326337635
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
205941 Issued in LA
Practice address
256 Highway 3048
Rayville, LA 71269-3624
Phone
(318) 728-2046
Fax
(318) 728-9371
NPI assigned
Apr 7, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 205941 LA Primary

Addresses

Primary practice location

256 Highway 3048
Rayville, LA 71269-3624

Mailing address

256 Highway 3048
Rayville, LA 71269-3624
Phone (318) 728-2046

Other practice location 1

1012 Louisa St
Rayville, LA 71269-2957
Phone (318) 728-2046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210001270 LA Practitioner - Emergency MedicinePractitioner - Family Practice 0042447443 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland Parish Hospital Service District No 1-BGroup PAC ID 2163481599, shared by 3 NPIs, 41 clinicians

Practice addresses (Care Compare)

254 Hwy 3048
Rayville, LA 71269-3624
Phone (318) 728-4181

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Parish Hospital Service District No 1-B Family Medicine CurrentSince Mar 2, 2014 Accepting new patients
Richland Parish Hospital Service District No 1-B Current Accepting new patients
Emergency Staffing Solutions Inc CurrentSince Mar 1, 2014 Accepting new patients
Ess Hospitalist LLC CurrentSince Mar 1, 2014 Accepting new patients
Colonial Manor Nursing and Rehabilitation Home Inc Past Accepting new patients
DSKH Rayville LLC Past Accepting new patients

Locations

207 Jefferson St
Mansfield, LA 71052
Phone (318) 871-3109

1012 Louisa St
Rayville, LA 71269
Phone (318) 728-2046

254 Highway 3048
Rayville, LA 71269
Phone (318) 728-4181

256 Highway 3048
Rayville, LA 71269
Phone (318) 728-2046

5975 Federal 80 Hwy
Rayville, LA 71269
Phone (318) 728-4368

1000 S Spruce St
Vivian, LA 71082
Phone 3183753235207

17304 Preston Rd
Ste 1400
Dallas, TX 75252
Phone (972) 934-3200

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Colonial Manor Nursing and Rehabilitation HomeRayville, LA, CCN 195394 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2018
Jan 1, 2018
Rayville Nursing and RehabilitationRayville, LA, CCN 195373 Skilled nursing facility Adp of the SNF Dec 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326337635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HIGHWAY 3048",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712693624",
            "telephone_number": "318-728-2046",
            "fax_number": "318-728-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 HIGHWAY 3048",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712693624",
            "telephone_number": "318-728-2046",
            "fax_number": "318-728-9371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 Louisa St",
            "address_purpose": "LOCATION",
            "city": "Rayville",
            "state": "LA",
            "postal_code": "712692957",
            "country_code": "US",
            "telephone_number": "318-728-2046",
            "fax_number": "318-728-9371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "205941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rayville, LA

Sources for this page

Verify at the official NPI Registry.