GEOFFREY THOMAS BOUC (NPI# 1609947159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609947159 |
| Entity Type | Individual |
| Full Name | GEOFFREY THOMAS BOUC |
| Credential | MD |
| Practice Address |
3005 Riverside Dr Suite 101 Beloit WI 53511-1500 |
| Practice Telephone | 6083657200 |
| Practice Fax Number | 6083657202 |
| Mailing Telephone | 6083657200 |
| Mailing Fax Number | 6083657202 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 36893 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32161500 | 05 |
| Street Address |
3005 RIVERSIDE DR SUITE 101 |
| City | BELOIT |
| State | WI |
| Zip Code | 53511-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437568540 | Jada Miller | Counselor | 3005 Riverside Dr, Suite 102, Beloit, WI 53511-1500 | 2014-08-04 |
| 1073944302 | Beloit Psychotherapy | Counselor | 3005 Riverside Dr, Suite 102, Beloit, WI 53511-1500 | 2013-12-12 |
| 1982978334 | Kari E. Bell | Counselor | 3005 Riverside Dr, Suite 102, Beloit, WI 53511-1500 | 2012-03-02 |
| 1356520563 | Bouc Family Wellness Center, LLC | Family Medicine | 3005 Riverside Dr, Suite 101, Beloit, WI 53511-1500 | 2007-10-24 |
| 1720208960 | Karen Lynn Dodson | Acupuncturist | 3005 Riverside Dr, Suite 201 Midwest Pain Treatment Center, Beloit, WI 53511 | 2007-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738485 | Linda Lee Cook | Technician | 914 Cranston Rd., Beloit, WI 53511 | 2019-09-05 |
| 1033773734 | Holistic Counseling Services, LLC | Counselor | 1517 Huebbe Parkway, Ste A, Beloit, WI 53511 | 2019-04-28 |
| 1578073870 | Bonita May Cooke | Counselor | 838 Grant St., Beloit, WI 53511 | 2017-10-02 |
| 1679091219 | Stacy Lynn Gallagher | Licensed Practical Nurse | 1060 Bittel St, Beloit, WI 53511 | 2017-09-04 |
| 1629448824 | Brenda Jean Allen | Registered Nurse | 2907 E. Leona Drive, Beloit, WI 53511 | 2015-09-30 |
| 1033595038 | Amber Noel Slaybaugh | Physical Therapist | 838 E. Azalea Ter., Beloit, WI 53511 | 2015-08-03 |
| 1407260326 | Quirt Family Dentistry, Sc | Dentist | 2777 Milwaukee Rd, Beloit, WI 53511 | 2014-06-18 |
| 1821436973 | Raymond K Spade | Counselor | 2240 Prairie Ave., Beloit, WI 53511 | 2013-06-11 |
| 1629321658 | Sarah Ann Nelson | Physical Therapist | 1905 W. Hart Road, Beloit, WI 53511 | 2012-10-15 |
| 1235494212 | Mary Ann Hudson | Nurse Practitioner | 700 College Street, Beloit College, Beloit, WI 53511 | 2012-07-06 |
| Find all providers in zip 53511 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306051636 | David Scott St. John | Family Medicine | 12700 Beloit Snodes Rd, Beloit, OH 44609-9212 | 2007-05-11 |
| 1558406637 | Eugene Adrian Gonzales | Family Medicine | 1735 Madison Rd, Beloit, WI 53511-3216 | 2007-02-20 |
| 1861557860 | Bruce E Greenfield | Family Medicine | 403 Wisconsin Ave, Beloit, WI 53511 | 2006-12-27 |
| 1982777421 | Jerome M Carrico | Family Medicine | 120 N Mill, Beloit, KS 67420 | 2006-11-15 |
| 1487753596 | Shamshad A. Anjum | Family Medicine | 1735 Madison Road, Westside Clinic, Beloit, WI 53511-3216 | 2006-09-22 |
| 1013925775 | Stephen R Rudisill | Family Medicine | 1650 Lee Lane, Occupation Health Sports & Family Medicine Center, Beloit, WI 53511-3935 | 2006-08-04 |
| 1285603977 | Christine Marie Marozas | Family Medicine | 1005 N Lincoln Ave, Beloit, KS 67420-1215 | 2006-03-15 |
| 1083142202 | Jennifer S. Cho-escalante | Family Medicine | Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 | 2017-06-01 |
| 1598125072 | Brittany N R Blomberg | Family Medicine | Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 | 2016-02-26 |
| 1003256975 | Imad M. Aziz | Family Medicine | 2825 Prairie Ave, Beloit, WI 53511-1844 | 2013-06-25 |
| Find all providers in BELOIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.