Active NPI
Linda Charles
- Nurse Practitioner
- Friendship, WI
National Provider Identifier
1912044462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2207-33
- Practice address
- 402 West Lake St.
Friendship, WI 53934 - Phone
- (608) 339-8370
- NPI assigned
- Jan 31, 2007
- Last updated
- Apr 29, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2207-33 | WI | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 2207 | WI |
Addresses
Primary practice location
402 West Lake St.
Friendship, WI 53934
Mailing address
402 West Lake St.
Friendship, WI 53934
Phone (608) 339-8370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41187000 | Medicaid | WI |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2207 | WI | MD | Gerontology Nurse Practitioner |
Interoperability endpoints
- lcharles291036@direct.gundersenhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430265600000",
"number": "1912044462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 WEST LAKE ST.",
"city": "FRIENDSHIP",
"state": "WI",
"postal_code": "53934",
"telephone_number": "608-339-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 WEST LAKE ST.",
"city": "FRIENDSHIP",
"state": "WI",
"postal_code": "53934",
"telephone_number": "608-339-8370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "LINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2015-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "2207-33",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "2207",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41187000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Friendship, WI
- Aspiring Horizons
- Virginia Lee Batie, APRN- FNP-C
- Kevin B. Beaver, PT
- William D Borkon, MD
- Brookridge Adult Family Home LLC
- Thomas L Charles, MSW, LCSW
- Emily Burzynski Clark, SLP
- Complete Care at Villa Pines LLC
- County of Adams (Adams County Health & Human Services Department)
- County of Adams (Adams County Health and Human Services)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.