Individual provider Active NPI

Jessica Carlisle, FNP

  • Family Nurse Practitioner
  • Garden City, KS
National Provider Identifier
1801502364
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
81880 Issued in KS
Practice address
512 N 7TH St
Garden City, KS 67846-5525
Phone
(620) 301-0304
Fax
(833) 629-0833
NPI assigned
Jan 27, 2023
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 81880 KS Primary

Addresses

Primary practice location

512 N 7TH St
Garden City, KS 67846-5525

Mailing address

512 N 7TH St
Garden City, KS 67846-5525
Phone (620) 301-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Dec 1, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Dec 1, 2023 Accepting new patients
Williams Medical Group Practice, LLC Past Accepting new patients

Locations

231 S Andover Rd
Andover, KS 67002
Phone (316) 733-9355

3800 10th St
Great Bend, KS 67530
Phone (620) 603-4216

Interoperability endpoints

  • Direct secure messaging: jessica.carlisle.1@14940.direct.athenahealth.com

Organizations & group practices 3

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": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1801502364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N 7TH ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465525",
            "telephone_number": "620-301-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N 7TH ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465525",
            "telephone_number": "620-301-0304",
            "fax_number": "833-629-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "81880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.