| Mrs Carly Jean Carlisle, MOT, OTR/L | |
|
120 Gabrielle Cir, Bethalto, IL 62010-2594 | |
| (618) 593-2909 | |
| Not Available |
| Full Name | Mrs Carly Jean Carlisle |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist In Private Practice |
| Experience | 10 Years |
| Location | 120 Gabrielle Cir, Bethalto, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932634714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 056011096 (Illinois) | Primary |
| 225X00000X | Occupational Therapist | 2015024426 (Missouri) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Healthcare Services Inc | 2163339722 | 3474 |
| Empowerme Rehabilitation Illinois Llc | 2365718277 | 334 |
| Comprehensive Therapeutics Ltd | 8921230137 | 271 |
| Provider Name | Comprehensive Therapeutics Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1699094102 PECOS PAC ID: 8921230137 Enrollment ID: O20140422000663 |
| Provider Name | Empowerme Rehabilitation Illinois Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1689141376 PECOS PAC ID: 2163339722 Enrollment ID: O20200427002510 |
| Provider Name | Empowerme Wellness Kansas City Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Carly Jean Carlisle, MOT, OTR/L 120 Gabrielle Cir, Bethalto, IL 62010-2594 Ph: (618) 593-2909 | Mrs Carly Jean Carlisle, MOT, OTR/L 120 Gabrielle Cir, Bethalto, IL 62010-2594 Ph: (618) 593-2909 |
Danielle Marie Atwood, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1008 2nd St, Bethalto, IL 62010 Phone: 618-581-2825 | |
Joseph B. Martin, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 335 Whispering Oaks Dr, Bethalto, IL 62010 Phone: 618-531-5985 Fax: 618-377-5882 | |
Amy Lynn Griffith, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 173 Patton Dr, Bethalto, IL 62010 Phone: 618-377-6188 Fax: 618-377-6188 |