DR. CHARLES E CLARK MD
NPI 1689713018
Family Medicine in Onalaska, WI

Q: What is Charles Clark's NPI number?

The NPI number for Charles Clark is 1689713018. It was assigned to this individual provider in the NPPES registry on February 5, 2007. The provider is also known as Dr. Charles E Clark MD.

Q: What is Charles Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on February 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 05, 2007PECOS Enrolled

3111 GUNDERSEN DR, ONALASKA, WI 54650(608) 775-8100 Get Directions Write a Review

NPPES record last updated: February 3, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Charles E Clark Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES E CLARK MD (NPI 1689713018) is an individual family medicine provider in Onalaska, Wisconsin, licensed in Wisconsin (51554) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689713018

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. CHARLES E CLARKCredential: MD

Location Address3111 GUNDERSEN DROnalaska, WI 54650-8447

Mailing Address1836 South AveLa Crosse, WI 54601-5429 · (608) 782-7300

Phone(608) 775-8100

Sole ProprietorNo

Enumeration DateFebruary 5, 2007

Last NPPES UpdateFebruary 3, 2015

✔ NPI 1689713018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WI · 51554✔ Licensed in NM · 96180

Definition

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.

3111 GUNDERSEN DR, Onalaska, WI 54650

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Other Names 1

Other Name (5)Dr. Charles E Clark Md

Other Identifiers 3

MedicaidQ4886NM

Medicare UPING54639

Medicare PIN$$$$$$$$$P

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles E Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54650 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENEE LYNN MONTI ATC

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