Active NPI
Rebecca L Charles, MD
- Pediatrics Physician
- Madison, WI
National Provider Identifier
1225072630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 42603-020
- Practice address
- 1313 Fish Hatchery Rd
Madison, WI 53715-1911 - Phone
- (608) 252-8000
- Fax
- (608) 283-7091
- NPI assigned
- Jun 15, 2006
- Last updated
- Dec 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 42603-020 | WI | Primary |
Addresses
Primary practice location
1313 Fish Hatchery Rd
Madison, WI 53715-1911
Mailing address
1808 W Beltline Hwy
Madison, WI 53713-2334
Phone (608) 280-4647
Other practice location 1
752 N High Point Rd
Dean Medical Center
Madison, WI 53717-2236
Phone (608) 824-4800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42603-020 | WI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1225072630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 W BELTLINE HWY",
"city": "MADISON",
"state": "WI",
"postal_code": "537132334",
"telephone_number": "608-280-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 FISH HATCHERY RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537151911",
"telephone_number": "608-252-8000",
"fax_number": "608-283-7091"
}
],
"practiceLocations": [
{
"address_1": "752 N High Point Rd",
"address_2": "Dean Medical Center",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537172236",
"country_code": "US",
"telephone_number": "608-824-4800",
"fax_number": "608-824-4910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHARLES",
"first_name": "REBECCA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "42603-020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.