Willard Roger Carlisle, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

7258 Issued in AL

Practice address

1 Independence PLZ
Suite 900
Birmingham, AL 35209-2629

Phone

(205) 271-8000

Fax

(205) 879-0548

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: willard.carlisle.1@18499.direct.athenahealth.com

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1275517377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PLZ",
            "address_2": "SUITE 900",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092629",
            "telephone_number": "205-271-8000",
            "fax_number": "205-879-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PLZ",
            "address_2": "SUITE 900",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092629",
            "telephone_number": "205-271-8000",
            "fax_number": "205-879-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "WILLARD",
        "middle_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "7258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528400180",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Carle
• Kendall Marie Carlis
• Anna Carlisle, LPC
• Sheila Pizzolato Carlisle, M.A.CCC/SLP
• Vicki P Carlisle, MD
• Waldemar Alberto Carlo, M.D.
• Waldemar F Carlo Jr., M.D.
• Molly S Carlsen, CRNA
• Barbra Diane Carlson
• Brandy Moss Carlson, LICSW-S, RPT-S

• Gastroenterology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Gastroenterology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.