MARY GRACE CARLISLE (CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104524875

MARY GRACE CARLISLE (CNP) is a healthcare provider. based in Westerville, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. 0033321 (OH). The NPI Number for MARY GRACE CARLISLE (CNP) is 1104524875

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
MARY GRACE CARLISLE (CNP)
NPI
1104524875
Phone
(614) 906-3223
Address
670 MERIDIAN WAY STE 165
Enumeration Date
21 February 2023
Last Update Date
5 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9377590545
Graduation Year
2022 (4 years ago)
PAC ID
7517332430
Group Practice PAC ID
8527462506
Professional Enrollment ID
I20230406002444
Address ID
OH453424926MI9049XPIKE300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for MARY GRACE CARLISLE (CNP)

  • 670 MERIDIAN WAY STE 165

    WESTERVILLE, OH 430822302

    Phone: (614) 906-3223

    Fax: (614) 639-8162

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 35 Open Payments records for all available years, with a total value of $567.

Total Amount is formed as General ($567) + Research ($0) + Ownership ($0) = $567.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: ABBVIE INC. ($349).

Total Amount

$567

General + Research + Ownership

Payments

35

Total payment records

General Amount

$567

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-04-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230406002444INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43082)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527462506View full group profile
NameSpecialtyState
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerMO

Reviews

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Frequently asked questions

Can I verify MARY GRACE CARLISLE (CNP) with an NPI only?
You can start verification with NPI 1104524875 for MARY GRACE CARLISLE (CNP), then check state licensing separately.
Is MARY GRACE CARLISLE (CNP) still practicing?
MARY GRACE CARLISLE (CNP) is currently listed as active in the public NPI registry.
What is MARY GRACE CARLISLE (CNP) best known for clinically?
Directory data describes MARY GRACE CARLISLE (CNP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MARY GRACE CARLISLE (CNP) based?
MARY GRACE CARLISLE (CNP) is tied to Westerville, Ohio in the data we show; additional addresses may exist on the full record.
Is the information about MARY GRACE CARLISLE (CNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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