Individual provider Active NPI

James W Smrecek, MD

  • Family Medicine Physician
  • Oshkosh, WI
National Provider Identifier
1063407385
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24813 Issued in WI
Practice address
1855 S Koeller St
Oshkosh, WI 54902-6186
Phone
(920) 223-7300
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24813 WI Primary

Addresses

Primary practice location

1855 S Koeller St
Oshkosh, WI 54902-6186

Mailing address

1855 S Koeller St
Oshkosh, WI 54902-6186
Phone (920) 223-7300

Other identifiers 1

IdentifierTypeStateIssuer
30663300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1063407385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026186",
            "telephone_number": "920-223-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026186",
            "telephone_number": "920-223-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMRECEK",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "24813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30663300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.