Individual provider Active NPI

Nicholas Dwayne Carlisle, D.C.

  • Chiropractor
  • Duluth, GA
National Provider Identifier
1356635023
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008621 Issued in GA
Practice address
3775 Venture Dr BLDG K
Duluth, GA 30096-5102
Phone
(678) 878-3149
Fax
(404) 420-2939
NPI assigned
May 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008621 GA Primary

Addresses

Primary practice location

3775 Venture Dr BLDG K
Duluth, GA 30096-5102

Mailing address

10945 State Bridge Rd Ste 401-160
Johns Creek, GA 30022-8164
Phone (404) 316-1190

Other practice location 1

217 Arrowhead Blvd Ste A2
Jonesboro, GA 30236-1169
Phone (678) 771-3060

Other practice location 2

5009 Roswell Rd Ste 201
Atlanta, GA 30342-2205
Phone (404) 264-9553

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

State licenses

LicenseStateTypeSpecialty
CHIR008621GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Semes Inc CurrentSince May 1, 2022 Accepting new patients

Locations

5009 Roswell Rd
Ste 120
Sandy Springs, GA 30342
Phone (404) 264-9553

Organizations & group practices 1

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1356635023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 STATE BRIDGE RD STE 401-160",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228164",
            "telephone_number": "404-316-1190",
            "fax_number": "404-420-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 VENTURE DR BLDG K",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965102",
            "telephone_number": "678-878-3149",
            "fax_number": "404-420-2939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Arrowhead Blvd Ste A2",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302361169",
            "country_code": "US",
            "telephone_number": "678-771-3060",
            "fax_number": "404-420-2939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5009 Roswell Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303422205",
            "country_code": "US",
            "telephone_number": "404-264-9553",
            "fax_number": "404-420-2939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "NICHOLAS",
        "middle_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.