DANIEL C MACCHARLES MD, NPI 1205839198 — LA CROSSE (WI)

NPI 1205839198

14+ Years Experience Individual

DANIEL C MACCHARLES MD

05/24/2005
PROVIDER ENUMERATION DATE
11.06.2015
LAST UPDATE DATE
1205839198
NPI NUMBER

About DANIEL C MACCHARLES

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DANIEL C MACCHARLES is a provider established in LA CROSSE, WI. The NPI number of DANIEL C MACCHARLES is 1205839198 and was assigned on 05/24/2005. The practitioners primary taxonomy code is: 207Q00000X with license number: 41101 WI .

Mailing address

  • City: LA CROSSE
  • State: WI
  • Postal code: 546015429
  • Phone: 6087827300
  • Address: 1836 SOUTH AVE

Primary Practice Address

  • Region : LA CROSSE, WI
  • NPI : 1205839198
  • Phone : 6087827300
  • Postalcode : 546015429
  • Address : 1836 SOUTH AVE

Additional identifiers

  • Identifier: 32564000
  • Code / Type : 5 - MEDICAID
  • Identifier state : WI

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Family Medicine

  • Taxonomy code: 207Q00000X
  • License number: 41101
  • License state: WI

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Contacts:

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  • DANIEL C MACCHARLES MD
  • Address : 1836 SOUTH AVE
  • Region : LA CROSSE, WI
  • NPI : 1205839198
  • Phone : 6087827300
  • Postalcode : 546015429

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1836 SOUTH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLA CROSSE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameWI
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code546015429
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6087827300
The telephone number associated with the location address of the provider being identified.
NPI1205839198
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207Q00000X
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider Enumeration Date05/24/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated11.06.2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DANIEL C MACCHARLES
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1836 SOUTH AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameLA CROSSE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameWI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code546015429
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6087827300
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1207Q00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider License Number 141101
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1WI
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 132564000
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1WI
Other Provider Identifier State #1
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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