Individual provider Active NPI

Christopher M. Barczak

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1801000591
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10495-024 Issued in WI
Practice address
500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone
(920) 223-0407
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10495-024 WI Primary

Addresses

Primary practice location

500 S Oakwood Rd
Oshkosh, WI 54904-7944

Mailing address

500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone (920) 223-0407

Other identifiers 1

IdentifierTypeStateIssuer
36125100MedicaidWI

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
10495-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1801000591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCZAK",
        "first_name": "CHRISTOPHER",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10495-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36125100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.