Organization Active NPI

FCHC Medical Care, LLC

  • Multi-Specialty Clinic/Center
  • Wauseon, OH
National Provider Identifier
1598821175
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
FCHC MEDICAL CARE, LLC
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(419) 335-2015
Fax
(419) 330-2649
NPI assigned
Dec 28, 2006
Last updated
Jun 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Patricia Finn
Title
Ceo
Phone
(419) 335-2015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1702

Mailing address

735 S Shoop Ave
Wauseon, OH 43567-1735
Phone (419) 335-3242

Other practice location 1

6696 US Highway 20A
Delta, OH 43515-9799
Phone (419) 822-3242

Other practice location 2

124 W Main St
Fayette, OH 43521-9618
Phone (419) 237-2501

Other practice location 3

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-6377

Other practice location 4

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 330-2708

Other practice location 5

495 S Shoop Ave
Wauseon, OH 43567-1719
Phone (419) 330-2790

Other practice location 6

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 330-2769

Other practice location 7

735 S Shoop Ave
Wauseon, OH 43567-1735
Phone (419) 337-7467

Other practice location 8

735 S Shoop Ave
Wauseon, OH 43567-1735
Phone (419) 335-2663

Other practice location 9

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-3333

Other practice location 10

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 337-7478

Other practice location 11

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-2500

Other practice location 12

735 S Shoop Ave
Wauseon, OH 43567-1735
Phone (419) 335-3242

Other identifiers 1

IdentifierTypeStateIssuer
2707324MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070103000005 OH Part B Supplier - Clinic/Group Practice 8022018704 Receives reassigned benefits from 68 practitioners
4 other NPIs on this enrollment
Practice locations: Archbold, OH; Wauseon, OH; Fayette, OH; Delta, OH
O20220706002093 OH MDPP Supplier - in-Person MDPP Supplier 8022018704 Practice locations: Wauseon, OH

National Provider Directory

National Provider Directory

Locations

L3493
Columbus, OH 43260

L4133
Columbus, OH 43260

124 W Main St
Fayette, OH 43521
Phone (419) 237-2501

735 S Shoop Ave
Wauseon, OH 43567
Phone (419) 335-2663

Interoperability endpoints

  • Direct secure messaging: katheryn.palmer@fultoncounty.medicity.net

Practitioners & affiliated clinicians

Practitioners 121

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1598821175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671735",
            "telephone_number": "419-335-3242",
            "fax_number": "193-355-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-335-2015",
            "fax_number": "419-330-2649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6696 US Highway 20A",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "OH",
            "postal_code": "435159799",
            "country_code": "US",
            "telephone_number": "419-822-3242",
            "fax_number": "419-822-9008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 W Main St",
            "address_purpose": "LOCATION",
            "city": "Fayette",
            "state": "OH",
            "postal_code": "435219618",
            "country_code": "US",
            "telephone_number": "419-237-2501",
            "fax_number": "419-237-2671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-335-6377",
            "fax_number": "419-335-6807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-330-2708",
            "fax_number": "419-330-2705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671719",
            "country_code": "US",
            "telephone_number": "419-330-2790",
            "fax_number": "419-330-2774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-330-2769",
            "fax_number": "419-330-2738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "735 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671735",
            "country_code": "US",
            "telephone_number": "419-337-7467",
            "fax_number": "419-337-7468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "735 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671735",
            "country_code": "US",
            "telephone_number": "419-335-2663",
            "fax_number": "419-335-9615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-335-3333",
            "fax_number": "419-337-7845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-337-7478",
            "fax_number": "419-337-7846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671702",
            "country_code": "US",
            "telephone_number": "419-335-2500",
            "fax_number": "419-335-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "735 S Shoop Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435671735",
            "country_code": "US",
            "telephone_number": "419-335-3242",
            "fax_number": "419-335-3222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FCHC MEDICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2021-06-07",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "FINN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-335-2015"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2707324",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.