Individual provider Active NPI

Quian Donald Carlisle

  • Occupational Therapist
  • Columbia, SC
National Provider Identifier
1356086383
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6172 Issued in SC
Practice address
4 Magnolia Glen LN
Columbia, SC 29205-4278
Phone
(184) 324-6229
NPI assigned
May 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6172 SC Primary

Addresses

Primary practice location

4 Magnolia Glen LN
Columbia, SC 29205-4278

Mailing address

4 Magnolia Glen LN
Columbia, SC 29205-4278
Phone (184) 324-6229

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

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Rehabilitation Occupational Therapist CurrentSince Mar 1, 2024 Accepting new patients
The Weston Group of South Carolina Inc Occupational Therapist CurrentSince Jun 7, 2022 Accepting new patients

Locations

1 Pond St
Arden, NC 28704
Phone 82877452220027

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

3959 Fish Hatchery Rd
Gaston, SC 29053
Phone (803) 755-6541

5422 Augusta Rd
Lexington, SC 29072
Phone (803) 520-5850

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": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1356086383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MAGNOLIA GLEN LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292054278",
            "telephone_number": "184-324-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MAGNOLIA GLEN LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292054278",
            "telephone_number": "184-324-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "QUIAN",
        "middle_name": "DONALD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.