Kevin Carlisle, MD
Individual provider Active NPI Family Medicine Physician · Rayville, LA
NPI 1326337635 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1326337635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 205941 (LA)
- Practice address
- 256 Highway 3048
Rayville, LA 71269-3624 - Phone
- (318) 728-2046
- Fax
- (318) 728-9371
- NPI assigned
- Apr 7, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 11
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- 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-B
Practice addresses (Care Compare)
254 Hwy 3048
Rayville, LA 71269-3624
Phone (318) 728-4181
Hospital & facility affiliations
- Trucare Home Health, LLC
- Primestar Home Health Inc
- Elara Caring
- St Francis Medical Center Home Health
- Premier Hospice, LLC
- Richardson Medical Center
- Richland Parish Hospital-Delhi
- Fmol Health St Francis
- Franklin Medical Center
- Colonial Manor Nursing & Rehabilitation Home
- Rayville Nursing and Rehabilitation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Colonial Manor Nursing and Rehabilitation Home |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2018 Jan 1, 2018 |
| Rayville Nursing and Rehabilitation |
Skilled nursing facility | Adp of the SNF | Dec 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131210001270 | LA | Practitioner - Emergency Medicine |
0042447443 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205941 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Parish Hospital Service District No 1-B | Family Medicine | Current |
Accepting new patients |
| Emergency Staffing Solutions Inc | Current |
Accepting new patients | |
| Richland Parish Hospital Service District No 1-B | Current | Accepting new patients | |
| Ess Hospitalist LLC | Current |
Accepting new patients | |
| DSKH Rayville LLC | Past | Accepting new patients | |
| Colonial Manor Nursing and Rehabilitation Home Inc | Past | Accepting new patients |
Locations
207 Jefferson St
Mansfield, LA 71052
Phone (318) 871-3109
256 Highway 3048
Rayville, LA 71269
Phone (318) 728-2046
254 Highway 3048
Rayville, LA 71269
Phone (318) 728-4181
1012 Louisa St
Rayville, LA 71269
Phone (318) 728-2046
1000 S Spruce St
Vivian, LA 71082
Phone 3183753235207
17304 Preston Rd
Ste 1400
Dallas, TX 75252
Phone (972) 934-3200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 205941 | LA | Yes |
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
Other providers in Rayville, LA
- Kyle Bruyninckx
- Sean Patrick Bryan
- Sarah Jane Buchanan
- Jessica Lynn Buckalew
- Cabuck Community Clinic
- Miriam Carmichael
- Tosha Danielle Cason
- CDM Medical Supplies, LLC
- Changing Lives Counseling and Mentoring, LLC
- Christy Chapman
All providers in Rayville, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.