JOHN CARLISLE (NPI# 1992783245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992783245 |
| Entity Type | Individual |
| Full Name | JOHN CARLISLE |
| Credential | M.D. |
| Practice Address |
1941 Johnson Ave # 101 San Luis Obispo CA 93401-4140 |
| Practice Telephone | 8057828844 |
| Practice Fax Number | 8057828859 |
| Mailing Telephone | 8057828844 |
| Mailing Fax Number | 8057828859 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2008-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G21420 | CA | Other Service Providers |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G21420 | CA | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G21420 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ28458Z | 01 |
| CA | GR0068680 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164962726 | John Austin Carlisle | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9020 | 2017-03-01 |
| 1538242318 | John W Carlisle | Dermatology | 2315 8th St, Lewiston, ID 83501-7301 | 2006-10-23 |
| 1992890339 | John Chamberlain Carlisle | Orthopaedic Surgery | 10701 Nall Ave, Suite 200, Overland Park, KS 66211-1363 | 2006-10-03 |
| Street Address |
1941 JOHNSON AVE # 101 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942204375 | Gary L. Harkins | Internal Medicine | 1941 Johnson Ave, Ste 201, San Luis Obispo, CA 93401-4169 | 2005-06-13 |
| 1689024259 | Pacific Central Coast Health Centers | Clinic/Center | 1941 Johnson Ave, Suite 105b, San Luis Obispo, CA 93401-4140 | 2016-06-15 |
| 1760896104 | Pacific Central Coast Health Centers | Clinic/Center | 1941 Johnson Ave, Suite 301, San Luis Obispo, CA 93401-4140 | 2014-06-13 |
| 1033544341 | Danae M Wilke | Physician Assistant | 1941 Johnson Ave, 101, San Luis Obispo, CA 93401-4140 | 2013-09-05 |
| 1316229289 | Pacific Central Coast Health Centers | Clinic/Center | 1941 Johnson Ave, Suite 301, San Luis Obispo, CA 93401-4140 | 2011-09-15 |
| 1679750574 | Armin J Bandari | Internal Medicine | 1941 Johnson Ave, Ste 101, San Luis Obispo, CA 93401-4154 | 2008-01-23 |
| 1215138789 | Andrea Hardison Tackett | Internal Medicine | 1941 Johnson Ave, Ste 101, San Luis Obispo, CA 93401-4154 | 2007-05-30 |
| 1689792327 | Christopher Paul Porterfield | Internal Medicine | 1941 Johnson Ave, Ste 101, San Luis Obispo, CA 93401-4154 | 2007-03-27 |
| 1699821959 | Lisa Michelle Winick | Advanced Practice Midwife | 1941 Johnson Ave, Suite 202, San Luis Obispo, CA 93401-4140 | 2007-01-26 |
| 1952496556 | Richard S Marks | Physician Assistant | 1941 Johnson Ave, San Luis Obispo, CA 93401-4140 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093126732 | Travis Freitas | Specialist | 3970 Broad St Ste 5, San Luis Obispo, CA 93401-7097 | 2014-05-15 |
| 1841519675 | David Goldeen | Specialist | 715 Dixie Ln, San Luis Obispo, CA 93401-8215 | 2010-05-18 |
| 1093947848 | Pediatric Physical Therapy & Services, Inc. | Specialist | 524 Kentucky St, San Luis Obispo, CA 93405-1913 | 2009-08-12 |
| 1730348053 | Jonathan Alan Abelson | Specialist | 100 Casa St Ste C, San Luis Obispo, CA 93405-8804 | 2008-06-02 |
| 1144405309 | California Retina Consultants | Specialist | 835 Aerovista Pl, Suite 110, San Luis Obispo, CA 93401-8740 | 2008-01-07 |
| 1609063635 | Lisa C Winstein | Specialist | 3217 Johnson Ave, #9, San Luis Obispo, CA 93401-6000 | 2007-10-03 |
| 1760517023 | Wendy Eda Shaw Dahl | Specialist | 1248 Laurel Ln, San Luis Obispo, CA 93401-5860 | 2007-02-23 |
| 1700951720 | Able Therapy Services | Specialist | 1411 Marsh St, Suite 107, San Luis Obispo, CA 93401-2957 | 2006-11-22 |
| 1902979636 | Ke-ping Tsao | Specialist | 1035 Peach St Ste 303, San Luis Obispo, CA 93401-2700 | 2006-11-17 |
| 1720152416 | Peter Andrew Lucier | Specialist | 12326 Los Osos Valley Road, San Luis Obispo, CA 93405 | 2006-11-17 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
Please comment or provide details below to improve the information on JOHN CARLISLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.