Organization Active NPI

Raymond W. Moy MD SC

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1740469873
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21142 Issued in WI
Legal business name
RAYMOND W. MOY MD SC
Practice address
6917 W Oklahoma Ave
Milwaukee, WI 53219-2973
Phone
(414) 545-7245
Fax
(414) 545-3373
NPI assigned
Oct 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Debbie Mokelke
Title
Billing
Phone
(414) 545-7245

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 21142 WI Primary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X 21142 WI
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 21142 WI

Addresses

Primary practice location

6917 W Oklahoma Ave
Milwaukee, WI 53219-2973

Mailing address

6917 W Oklahoma Ave
Milwaukee, WI 53219-2973
Phone (414) 545-7245

Other identifiers 1

IdentifierTypeStateIssuer
30254700MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1740469873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6917 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532192973",
            "telephone_number": "414-545-7245",
            "fax_number": "414-545-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532192973",
            "telephone_number": "414-545-7245",
            "fax_number": "414-545-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND W. MOY MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "MOKELKE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "414-545-7245"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21142",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "WI",
            "license": "21142",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "21142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30254700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.