Carlyle Care Clinic, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CARLYLE CARE CLINIC, PLLC

Practice address

509 E Millsap Rd Ste 107
Fayetteville, AR 72703-4862

Phone

(479) 480-7150

Fax

(479) 968-1673

NPI assigned

Jan 3, 2025

Organization subpart

No

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

Authorized official

Name

Benjamin Wagner Carlyle, MDNPI 1184882383

Title

Authorized Official

Phone

(479) 498-6700

Specialties & licenses 1

Addresses

Other names 1

• Prestige Hormone Health & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Wagner Carlyle, M.D.

  • Internal Medicine Physician
  • Farmington, AR
  • NPI 1184882383

  AR, Internal Medicine

  Medicare reassignment NPD Authorized official
• Alison A. Knox, APRN

  • Family Nurse Practitioner
  • Bentonville, AR
  • NPI 1215545298

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1508675612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "800-824-4094",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E MILLSAP RD STE 107",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034862",
            "telephone_number": "479-480-7150",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLYLE CARE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "CARLYLE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "WAGNER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "479-498-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Hormone Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin A Carey, MHPP
• Sheena Carllee, MD
• Tyler Lewis Carllee, M.D.
• Kellye Flemming Carlton, LPC
• Carly Stern, Licensed Clinical Social Worker Inc.
• Samantha Carmean
• Laura Lynn Carmical
• Trina Carmon, DPT
• Lesley Carnes, MHPP
• Jessica Carney, SLP

• All providers in Fayetteville, AR
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.