NPIMap

Individual provider Active NPI

Christine Janet Van Dyke, PA-C

  • Physician Assistant
  • Prairie Du Sac, WI
National Provider Identifier
1083772982
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17604 Issued in CA
Practice address
260 26TH St
Prairie Du Sac, WI 53578-2203
Phone
(608) 643-3311
NPI assigned
Dec 4, 2006
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2009019852 MO
Physician Assistant 363A00000X PA17604 CA Primary

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-2203

Mailing address

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-3311

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sph@direct.saukprairiehealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170914002517 WI Practitioner - Physician Assistant 4385799113 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upland Hills Health IncGroup PAC ID 3072415553, shared by 13 NPIs, 97 clinicians

Practice addresses (Care Compare)

1883 Springdale St
Mount Horeb, WI 53572-2477
Phone (608) 437-8040

551 Main St
Highland, WI 53543-9779
Phone (608) 929-4518

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17604CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sauk Prairie Healthcare, Inc. CurrentSince Nov 7, 2017 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Jan 10, 2018 Accepting new patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Upland Hills Health, Inc CurrentSince Jan 1, 2025 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Nov 1, 2025 Accepting new patients
Upland Hills Health, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Jan 10, 2018 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Emergency Physicians of Mid Missouri PC Past Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

Interoperability endpoints

  • Direct secure messaging: cvandyke263840@direct-ehr-ssmhc.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sph@direct.saukprairiehealthcare.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1083772982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "CHRISTINE",
        "middle_name": "JANET",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009019852",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sph@direct.saukprairiehealthcare.org",
            "affiliation": "N",
            "address_1": "260 26th St",
            "city": "Prairie Du Sac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535782203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.