Individual provider Active NPI

Charles R Strancke Jr., MD

  • Emergency Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1174546667
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36654 Issued in WI
Practice address
2629 N 7TH St
Sheboygan, WI 53083-4932
Phone
(920) 451-5553
Fax
(920) 451-5113
NPI assigned
Jul 25, 2006
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36654 WI Primary

Addresses

Primary practice location

2629 N 7TH St
Sheboygan, WI 53083-4932

Mailing address

2629 N 7TH St
Sheboygan, WI 53083-4932
Phone (920) 451-5553

Other identifiers 1

IdentifierTypeStateIssuer
32123800MedicaidWI

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
36654WIMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1174546667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5553",
            "fax_number": "920-451-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5553",
            "fax_number": "920-451-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRANCKE",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "36654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32123800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.