Robert Louis Carlisle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29798 Issued in CO

Practice address

3937 Ivywood LN
Pueblo, CO 81005-2551

Phone

(719) 553-0111

Fax

(719) 553-0117

NPI assigned

May 5, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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.

• Las Animas-Huerfano Counties District Health Department

  • Public Health or Welfare Agency
  • Trinidad, CO
  • NPI 1760540900
  Medicare reassignment NPD
• Trinidad Medical Associates , LLC

  • Family Medicine Physician
  • Trinidad, CO
  • NPI 1144273830
  NPD Authorized official

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1689622920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-0111",
            "fax_number": "719-553-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 IVYWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052551",
            "telephone_number": "719-553-0111",
            "fax_number": "719-553-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "29798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01297985",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carecorner Counseling LLC
• Kim Carere, RDH
• Emily Elizabeth Caricato
• Caring Hearts
• Lindsay Carleton
• Michelle Carlo, RDH
• Darla Marie Carlock, PTA, CCI
• Carlos Rodriguez, PH.D., P.C.
• Aileen Carlos, FNP
• Carlotta J. Fendrich, LLC

• Family Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.