Individual provider Active NPI

Christian J Streck, M.D.

  • Surgery Physician
  • Greensboro, NC
National Provider Identifier
1124001615
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22633 Issued in NC
Practice address
1002 N Church St
Suite 302
Greensboro, NC 27401-1439
Phone
(336) 387-8100
Fax
(336) 387-8202
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 22633 NC Primary

Addresses

Primary practice location

1002 N Church St
Suite 302
Greensboro, NC 27401-1439

Mailing address

1002 N Church St
Suite 302
Greensboro, NC 27401-1439
Phone (336) 387-8100

Other identifiers 1

IdentifierTypeStateIssuer
8980310MedicaidNC

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

State licenses

LicenseStateTypeSpecialty
22633NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Private Diagnostic Clinic, PLLC Past Accepting new patients
Central Carolina Surgery, P.a. Surgery PastSince Aug 1, 1995 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1124001615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "SUITE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "SUITE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRECK",
        "first_name": "CHRISTIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "22633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980310",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.