Carl W Byerly, PH.D.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AS630417869 Issued in MI

Practice address

6490 Eastlawn Ave
Clarkston, MI 48346-2422

Phone

(810) 691-6400

Fax

(248) 574-5999

NPI assigned

Jan 5, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Byerly Enterprises II, LLC

  • Assisted Living Facility
  • Clarkston, MI
  • NPI 1225854144
  NPD Authorized official

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1669242103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4759 OWASCO CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482273",
            "telephone_number": "810-691-6400",
            "fax_number": "248-574-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 EASTLAWN AVE",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462422",
            "telephone_number": "810-691-6400",
            "fax_number": "248-574-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYERLY",
        "first_name": "CARL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AS630417869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Burr
• Melinda Buss, PT, DPT
• Chelsea Buzzitta, M.A.
• Byerly Enterprises II, LLC
• Byerly Enterprises, LLC
• Kimberly Jill Byrd, LMSW
• Kevin Sean Byrne, DPT
• Kimberly Cabe, FNP
• Ricardo Q. Cabrera, M.D.
• Jennifer Ann Callender-Wright, OTR/L

• Assisted Living Facility in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.