Individual provider Active NPI

Christopher Fancher, SAC-IT

  • Addiction (Substance Use Disorder) Counselor
  • Racine, WI
National Provider Identifier
1750612255
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15900130 Issued in WI
Practice address
6233 Bankers Rd
Suite 10
Racine, WI 53403-9700
Phone
(262) 549-6600
Fax
(262) 549-6698
NPI assigned
Jan 22, 2010
Last updated
Jan 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15900130 WI Primary

Addresses

Primary practice location

6233 Bankers Rd
Suite 10
Racine, WI 53403-9700

Mailing address

2422 N Grandview Blvd
Waukesha, WI 53188-6105
Phone (262) 549-6600

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15900130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1750612255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 N GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886105",
            "telephone_number": "262-549-6600",
            "fax_number": "262-549-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6233 BANKERS RD",
            "address_2": "SUITE 10",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534039700",
            "telephone_number": "262-549-6600",
            "fax_number": "262-549-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANCHER",
        "first_name": "CHRISTOPHER",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15900130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.