Individual provider Active NPI

Joel Charles, M.D., M.P.H.

  • Family Medicine Physician
  • Soldiers Grove, WI
National Provider Identifier
1194143487
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6797920 Issued in WI
Practice address
102 Sunset Ave
Soldiers Grove, WI 54655
Phone
(608) 624-5203
NPI assigned
Apr 3, 2014
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 6797920 WI Primary

Addresses

Primary practice location

102 Sunset Ave
Soldiers Grove, WI 54655

Mailing address

102 Sunset Ave
Soldiers Grove, WI 54655-1400
Phone (608) 624-5203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109001574 WI Practitioner - Family Practice 5597058180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vernon Memorial Healthcare IncGroup PAC ID 8325958416, shared by 6 NPIs, 73 clinicians

Practice addresses (Care Compare)

102 Sunset Ave
Soldiers Grove, WI 54655-1400
Phone (608) 624-5203

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6797920WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vernon Memorial Healthcare, Inc Current Accepting new patients
Vernon Memorial Healthcare, Inc. CurrentSince Dec 18, 2017 Accepting new patients
Vernon Memorial Healthcare, Inc. CurrentSince Dec 18, 2017 Accepting new patients

Locations

206 N Mill St
La Farge, WI 54639
Phone (608) 625-2494

102 Sunset Ave
Soldiers Grove, WI 54655
Phone (608) 624-5203

407 S Main St
Ste 400
Viroqua, WI 54665
Phone (608) 637-3174

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

100 Melby St
Westby, WI 54667
Phone (608) 634-3125

Interoperability endpoints

  • Direct secure messaging: jcharles60546@direct.emplifyhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1194143487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SUNSET AVE",
            "city": "SOLDIERS GROVE",
            "state": "WI",
            "postal_code": "546551400",
            "telephone_number": "608-624-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SUNSET AVE",
            "city": "SOLDIERS GROVE",
            "state": "WI",
            "postal_code": "54655",
            "telephone_number": "608-624-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JOEL",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "6797920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldiers Grove, WI

Sources for this page

Verify at the official NPI Registry.