Active NPI
Lee K Carlisle, APRN, BC, FNP
- Family Nurse Practitioner
- San Angelo, TX
National Provider Identifier
1164423943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 553982
- Practice address
- 1610 S Chadbourne St
San Angelo, TX 76903-8510 - Phone
- (325) 658-5339
- Fax
- (325) 659-8524
- NPI assigned
- Aug 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 553982 | TX | Primary |
Addresses
Primary practice location
1610 S Chadbourne St
San Angelo, TX 76903-8510
Mailing address
2029 W Beauregard Ave
San Angelo, TX 76901-3812
Phone (325) 658-5339
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111604802 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 553982 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1164423943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2029 W BEAUREGARD AVE",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769013812",
"telephone_number": "325-658-5339",
"fax_number": "325-659-8524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 S CHADBOURNE ST",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769038510",
"telephone_number": "325-658-5339",
"fax_number": "325-659-8524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLISLE",
"first_name": "LEE",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "APRN, BC, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "553982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111604802",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.