NPIMap

Organization Active NPI

Medical Associates of Clinton, Iowa, P.L.C.

Doing business as Fulton Family Health Clinic

  • Family Medicine Physician
  • Fulton, IL
National Provider Identifier
1568416022
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.
Doing business as
Fulton Family Health Clinic
Practice address
1705 16TH Ave
Fulton, IL 61252-9708
Phone
(815) 589-2121
Fax
(815) 589-4468
NPI assigned
May 20, 2006
Last updated
Mar 15, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDICAL ASSOCIATES OF CLINTON, IOWA PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Thomas A Moser
Title
Chief Operating Officer
Phone
(563) 243-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1705 16TH Ave
Fulton, IL 61252-9708

Mailing address

915 13TH Ave N
Clinton, IA 52732-5067
Phone (563) 243-2511

Other names 1

  • Fulton Family Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Med Assoc Cardiology6 organizations share this tax ID, including this one
Part of
Med Assoc Cardiology

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1568416022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 16TH AVE",
            "city": "FULTON",
            "state": "IL",
            "postal_code": "612529708",
            "telephone_number": "815-589-2121",
            "fax_number": "815-589-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF CLINTON, IOWA PLC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "563-243-2511"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fulton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.