Individual provider Active NPI

Cameron Ray Carlisle, MS, CCC-SLP

  • Speech-Language Pathologist
  • Little Rock, AR
National Provider Identifier
1801040266
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1846 Issued in AR
Practice address
11517 Kanis Rd
Little Rock, AR 72211-3724
Phone
(501) 993-7171
Fax
(501) 223-8075
NPI assigned
Nov 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1846 AR Primary

Addresses

Primary practice location

11517 Kanis Rd
Little Rock, AR 72211-3724

Mailing address

8 Cherry Creek CV
Little Rock, AR 72212-2005
Phone (501) 227-7372

Other identifiers 1

IdentifierTypeStateIssuer
148300721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1846ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Company Past Accepting new patients
Pediatric Therapy Services of Little Rock Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1801040266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHERRY CREEK CV",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722122005",
            "telephone_number": "501-227-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11517 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113724",
            "telephone_number": "501-993-7171",
            "fax_number": "501-223-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "CAMERON",
        "middle_name": "RAY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "1846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148300721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.