NPIMap

Individual provider Active NPI

Brandon Colby Carlisle, PA-C

  • Medical Physician Assistant
  • Roanoke Rapids, NC
National Provider Identifier
1407212699
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130
Phone
(252) 537-9176
Fax
(252) 537-6851
NPI assigned
Jan 5, 2016
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130

Mailing address

1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130
Phone (252) 537-9176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302002631 NC Practitioner - Physician Assistant 3971809815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1385 Medical Ctr Dr
Roanoke Rapids, NC 27870-5130
Phone (252) 537-9176

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Valley Health Services Inc CurrentSince Jan 15, 2016 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Roanoke Valley Health Services Inc CurrentSince Jan 15, 2016 Accepting new patients
Roanoke Valley Health Services Inc CurrentSince Jan 15, 2016 Accepting new patients
Roanoke Valley Health Services Inc Past Accepting new patients
Roanoke Valley Health Services Inc Past Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1385 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 537-9176

210 Smith Church Rd
Ste B
Roanoke Rapids, NC 27870
Phone (252) 535-8870

240 Smith Church Rd
Ste A
Roanoke Rapids, NC 27870
Phone (252) 399-7055

306 Becker Dr
Roanoke Rapids, NC 27870
Phone (252) 537-9268

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1407212699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 MEDICAL CENTER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705130",
            "telephone_number": "252-537-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 MEDICAL CENTER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705130",
            "telephone_number": "252-537-9176",
            "fax_number": "252-537-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "BRANDON",
        "middle_name": "COLBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.