{"npi":"1669467833","type":"NPI-1","status":"active","name":{"display":"Mr. Kevin Carlisle P.A.","other":[],"first":"KEVIN","last":"CARLISLE","middle":"K","credential":"P.A."},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"FL","license":"PA1682"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"FL","license":"PA1682"}]},"addresses":[{"purpose":"LOCATION","street_1":"12880 COMMODITY PL","city":"TAMPA","state":"FL","postal_code":"336263101","country_code":"US","phone":"8133435500","fax":"8664627445"},{"purpose":"MAILING","street_1":"PO BOX 21686","city":"TAMPA","state":"FL","postal_code":"336221686","country_code":"US","phone":"8133435500","fax":"8664627445"}],"license":{"state":"FL","number":"PA1682"},"identifiers":[{"type_code":"01","label":"Other","value":"650420578","state":"FL","issuer":"CHAMPUS/TRICARE"},{"type_code":"01","label":"Other","value":"X1592","state":"FL","issuer":"BLUE CROSS BLUE SHIELD"},{"type_code":"05","label":"Medicaid","value":"290188900","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040419001106","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"FL","pac_id":"2769477785"}]},"enumeration_date":"2005-09-14","last_updated":"2026-03-04","_meta":{"source":"NPPES","snapshot_date":"2026-03-04","doc_url":"https://findmynpi.com/api"}}