Active NPI
Moncarm A Fouche, M.D.
- Internal Medicine Physician
- Grand Island, NE
National Provider Identifier
1821082603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 22262
- Practice address
- 2201 N Broadwell Ave
Grand Island, NE 68803-2153 - Phone
- (308) 258-0577
- Fax
- (308) 389-5111
- NPI assigned
- Sep 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36010 | IA | |
| Internal Medicine Physician | 207R00000X | 22262 | NE | Primary |
Addresses
Primary practice location
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Mailing address
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone (308) 258-0577
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 |
|---|---|---|---|
| 36010 | IA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Carmel Health | Past | Accepting new patients | |
| Alegent Health Bergan Mercy Health System | Past | Accepting new patients | |
| The Physician Network | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1821082603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 N BROADWELL AVE",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032153",
"telephone_number": "308-258-0577",
"fax_number": "308-389-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 N BROADWELL AVE",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032153",
"telephone_number": "308-258-0577",
"fax_number": "308-389-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUCHE",
"first_name": "MONCARM",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "36010",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NE",
"license": "22262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.