Jeremy Carlisle, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

37444 Issued in MT

Practice address

216 14TH Ave SW
Sidney, MT 59270-3519

Phone

(406) 488-2100

NPI assigned

Feb 18, 2009

Last updated

Feb 24, 2024By the provider in NPPES

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 names 1

• Mr. Jeremy Carlisle Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT, OR, WY, UT, WA5 enrollments

Enrollment records 5

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Okanogan County Public Hospital District No. 3Group PAC ID 6800707951, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mid Valley Hospital & Clinic Hospital, Omak, WA, CCN 501328

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcarlisle2073885@wm.providencedirect.org

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.

• Anesthesia Associates Northwest LLC

  • Anesthesiology Physician
  • Milwaukie, OR
  • NPI 1548281751
  Medicare reassignment Care Compare group NPD
• Okanogan County Public Hospital District No. 3

  dba Mid-Valley Hospital

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Medicare reassignment Care Compare group NPD
• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Daly Hospital

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Medicare reassignment NPD
• Montana Gastroenterology, PLLC

  • Clinic/Center
  • Missoula, MT
  • NPI 1821612946
  Medicare reassignment NPD
• Amsurg St George Anesthesia, LLC

  • Anesthesiology Physician
  • St George, UT
  • NPI 1730452814
  Medicare reassignment NPD
• Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Casper, WY
  • NPI 1811909807
  Medicare reassignment NPD
• Springfield Or Anesthesia Associates LLC

  dba Springfield Or Anesthesia

  • Certified Registered Nurse Anesthetist
  • Springfield, OR
  • NPI 1487158390

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Nephrology

  • Nephrology Physician
  • Hamilton, MT
  • NPI 1235997958
  NPD
• St. John's Lutheran Hospital, Inc.

  dba Cabinet Peaks Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Libby, MT
  • NPI 1588720882
  NPD (past)
• St George Endoscopy Center LLC

  dba St. George Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • St George, UT
  • NPI 1457325573
  NPD (past)

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

• Okanogan County Public Hospital District No. 3

  dba Mid-Valley Hospital

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Care Compare affiliation

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1437398229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "406-488-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "406-488-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "37444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcarlisle2073885@wm.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "Barrett Hospital Development Corporation",
            "address_1": "600 MT Hwy 91 South",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597253597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "CARLISLE",
            "prefix": "MR.",
            "credential": "CRNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Adrianne Bryant, PA-C
• Kimberly Ann Burgess, MD
• Tanya Lynn Candee, RN
• Patricia E Cantrell, PAC
• John Edward Carey, MD
• Carlos F. Trevino, M.D., P.C.
• Charlotte Rose Carlson, LCPC
• Central Medispa LLC
• Lisa J Christensen
• Orin Pete Council, MD PC

• Certified Registered Nurse Anesthetist in Sidney, MT
• Providers in Sidney, MT by specialty
• Certified Registered Nurse Anesthetist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.