Rene Martin Earles, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

54674-20 Issued in WI

Practice address

2221 S Webster Ave
Ste 241
Green Bay, WI 54301-2158

Phone

(920) 965-0345

Fax

(920) 273-6011

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FIBADD

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.

• Advocate Health Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1639111933
  NPD (past)
• Associated Foot Surgeons of Belleville, LTD.

  • Foot & Ankle Surgery Podiatrist
  • Belleville, IL
  • NPI 1538203377
  NPD (past)
• Associated Foot Surgeons of Southwest Illinois, LTD.

  • Foot & Ankle Surgery Podiatrist
  • Belleville, IL
  • NPI 1740653591
  NPD (past)
• New Dermatology Group LTD

  • Dermatology Physician
  • Iron Mountain, MI
  • NPI 1710321633
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1609946292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 S WEBSTER AVE",
            "address_2": "STE 241",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012158",
            "telephone_number": "920-965-0345",
            "fax_number": "920-273-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 S WEBSTER AVE",
            "address_2": "STE 241",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012158",
            "telephone_number": "920-965-0345",
            "fax_number": "920-273-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLES",
        "first_name": "RENE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036044864",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "54674-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0021606246",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Maitland Dvorak, M.D.
• Haley N Dyer, MS
• Dynamic Chiropractic, LTD
• Peter Dzwonkowski, MD
• Donna Kay Eads, LCSW
• East Side Chiropractic and Laser Therapy Center LLC
• East Side Family Practice SC
• Eastridge Dental Associates, S.C.
• Benjamin James Ebben, MD
• Emily M Ebben, LPC

• Dermatology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.