Robert W Lisle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32158 Issued in SC

Practice address

11 Arley Way
Suite 201
Bluffton, SC 29910-4883

Phone

(843) 706-8690

Fax

(843) 706-5066

NPI assigned

Jun 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Beaufort County Memorial Hospital

  • Internal Medicine Physician
  • Beaufort, SC
  • NPI 1598713117
  Medicare reassignment NPD
• Beaufort County Memorial Hospital

  • Emergency Medicine Physician
  • Beaufort, SC
  • NPI 1871335018
  NPD

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1619916012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ARLEY WAY",
            "address_2": "SUITE 201",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104883",
            "telephone_number": "843-706-8690",
            "fax_number": "843-706-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ARLEY WAY",
            "address_2": "SUITE 201",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104883",
            "telephone_number": "843-706-8690",
            "fax_number": "843-706-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISLE",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D14318",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL GBMC",
            "identifier": "S1420009",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MD GBMC",
            "identifier": "KJ24GB-41705201",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026441500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Stephanie Liedtke, PA-C
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• Limitless Pediatric Solutions
• Melissa Linsley
• Alexis Michelle Lipps, RN
• Jarrod Alexander Little, MD
• Laureen A Littlejohn, LISW-CP
• Laura Longer, CLC
• Jennifer Lopez
• Lotus Health, LLC

• Family Medicine Physician in Bluffton, SC
• Providers in Bluffton, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.