Individual provider Active NPI

Ernest Christopher Carlisle, DPT

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1780914143
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6078 Issued in SC
Practice address
18 Professional Village Cir
Beaufort, SC 29907-1570
Phone
(843) 986-9670
Fax
(843) 986-9369
NPI assigned
Jan 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6078 SC Primary

Addresses

Primary practice location

18 Professional Village Cir
Beaufort, SC 29907-1570

Mailing address

18 Professional Village Cir
Beaufort, SC 29907-1570
Phone (843) 986-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180207002012 CO Practitioner - Physical Therapist in Private Practice 9830233253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waldron's Peak Physical Therapy PCGroup PAC ID 4284524836, 5 clinicians

Practice addresses (Care Compare)

5387 Manhattan Cir
Suite 100a
Boulder, CO 80303-4283
Phone (303) 543-7878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6078SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Waldron's Peak Physical Therapy, P.C. Physical Therapist CurrentSince Jan 29, 2018 Accepting new patients

Locations

5387 Manhattan Cir
#100A
Boulder, CO 80303

5387 Manhattan Cir
Ste 100A
Boulder, CO 80303
Phone (303) 499-6818

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1780914143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PROFESSIONAL VILLAGE CIR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071570",
            "telephone_number": "843-986-9670",
            "fax_number": "843-986-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PROFESSIONAL VILLAGE CIR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071570",
            "telephone_number": "843-986-9670",
            "fax_number": "843-986-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "ERNEST",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.