Active NPI
Kwame G. Foucher, M.D.
- Family Medicine Physician
- Hammond, IN
National Provider Identifier
1336209527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01076051A
- Practice address
- 559 State St
Hammond, IN 46320-1533 - Phone
- (219) 937-3300
- Fax
- (219) 803-7252
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-114411 | IL | |
| Family Medicine Physician | 207Q00000X | 01076051A | IN | Primary |
Addresses
Primary practice location
559 State St
Hammond, IN 46320-1533
Mailing address
3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 949-7770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036114411 | Medicaid | IL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-114411 | IL | MD | Family Medicine Physician |
| 01076051A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450828800000",
"number": "1336209527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3241 S MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163878",
"telephone_number": "312-949-7770",
"fax_number": "312-949-7742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 STATE ST",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463201533",
"telephone_number": "219-937-3300",
"fax_number": "219-803-7252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUCHER",
"first_name": "KWAME",
"middle_name": "G.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2015-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-114411",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01076051A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036114411",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hammond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.