Family Medical Care Associates, S.C.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

21633 Issued in WI

Legal business name

FAMILY MEDICAL CARE ASSOCIATES, S.C.

Practice address

123 Hospital Dr
Suite 2004
Watertown, WI 53098-3331

Phone

(920) 206-7772

Fax

(920) 206-1001

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Moe Louie Chin, M.D.

Title

President

Phone

(920) 206-7772

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386738672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "SUITE 2004",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983331",
            "telephone_number": "920-206-7772",
            "fax_number": "920-206-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "SUITE 2004",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983331",
            "telephone_number": "920-206-7772",
            "fax_number": "920-206-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CARE ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "MOE",
        "authorized_official_middle_name": "LOUIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-206-7772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "21633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30315300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Watertown, WI
• Providers in Watertown, WI by specialty
• Geriatric Medicine (Family Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.