Charles R Leadholm, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

20148 Issued in WI

Practice address

252 McHenry St
Burlington, WI 53105-1828

Phone

(262) 767-6100

Fax

(262) 767-6098

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Associated Emergency Room Physicans, SC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Burlington, WI
  • NPI 1932161783
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194787846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 S 13TH ST",
            "address_2": "STE 104",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541466",
            "telephone_number": "414-570-7106",
            "fax_number": "414-570-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6100",
            "fax_number": "262-767-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADHOLM",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "20148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30775700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Lange, PA
• Regina Lara, L.P.N.
• Gerry K Larmore, MD
• Geraldine Larsen
• Kelly Marie Gallois Larson, NP
• Nathan M Lebak, MD
• Michelle M Lebas-Bowen, SLP
• Amy Lee, RD CD CDE
• Kevin Douglas Liberty, DPM
• Kathryn Marie Lindemann

• Emergency Medical Services (Emergency Medicine) Physician in Burlington, WI
• Providers in Burlington, WI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.