SHELLI KS CARSON (MS, CCC-A) – Audiologist, NPI 1407997265

SHELLI KS CARSON (MS, CCC-A) is a healthcare provider. based in Fayetteville, Arkansas. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials MS, CCC-A. They hold a License No. ASHA #01115396 (AR). The NPI Number for SHELLI KS CARSON (MS, CCC-A) is 1407997265

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
SHELLI KS CARSON (MS, CCC-A)
NPI
1407997265
Phone
(479) 443-6511
Address
1970 E JOYCE BLVD STE 2
Enumeration Date
12 February 2007
Last Update Date
10 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4795210455
Graduation Year
1994 (32 years ago)
PAC ID
1557528478
Group Practice PAC ID
4789662131
Professional Enrollment ID
I20120206000142
Address ID
AR727032885FA2100XRDXX502
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

74 QUALIFIED AUDIOLOGIST in AR

Provider Addresses for SHELLI KS CARSON (MS, CCC-A)

  • 1970 E JOYCE BLVD STE 2

    FAYETTEVILLE, AR 727035135

    Phone: (479) 443-6511

    Type: Mailing

  • 3400 S 70th St Ste B

    Fort Smith, AR 729035292

    Phone: (479) 974-9880

    Type: Location

  • 3394, North Futrall Drive, Fayetteville, Washington County, Arkansas, 72703, United States

    STE 1

    FAYETTEVILLE, AR 727034057

    Phone: (479) 582-4327

    Fax: (479) 582-4329

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120206000142IQualified AudiologistARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72703)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789662131View full group profile
NameSpecialtyState
Otolaryngology, Allergy/ImmunologyAR
Physician AssistantAR
Qualified AudiologistAR
Nurse PractitionerAR

Reviews

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Frequently asked questions

Can I verify SHELLI KS CARSON (MS, CCC-A) with an NPI only?
You can start verification with NPI 1407997265 for SHELLI KS CARSON (MS, CCC-A), then check state licensing separately.
Is SHELLI KS CARSON (MS, CCC-A) still practicing?
SHELLI KS CARSON (MS, CCC-A) is currently listed as active in the public NPI registry.
What taxonomy line describes SHELLI KS CARSON (MS, CCC-A)?
For research purposes, treat SHELLI KS CARSON (MS, CCC-A) as Audiologist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect SHELLI KS CARSON (MS, CCC-A) on a map?
Expect Fayetteville, Arkansas as a primary anchor for SHELLI KS CARSON (MS, CCC-A) unless the record lists multiple sites.
Why does SHELLI KS CARSON (MS, CCC-A) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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