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BOUC FAMILY WELLNESS CENTER, LLC
NPI 1356520563
Family Medicine in Beloit, WI

Active since October 24, 2007
3005 RIVERSIDE DR, SUITE 101, BELOIT, WI 53511(608) 365-7200(608) 365-7202 Get Directions Write a Review

NPPES record last updated: April 26, 2018. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Bouc Family Wellness Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOUC FAMILY WELLNESS CENTER, LLC (NPI 1356520563) is a healthcare organization registered as a family medicine in Beloit, Wisconsin and active in the NPI registry since October 2007. The organization lists Geoffrey T Bouc, Physician, as its authorized official.

NPPES Registry Identity

NPI1356520563
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBOUC FAMILY WELLNESS CENTER, LLC
Location Address3005 RIVERSIDE DR, SUITE 101Beloit, WI 53511-1500
Mailing Address3005 Riverside Dr, Suite 101Beloit, WI 53511-1500 · (608) 365-7200 · Fax (608) 365-7202
Phone(608) 365-7200
Fax(608) 365-7202
Organization SubpartNo
Authorized OfficialGeoffrey T BoucPhysician · (608) 365-7200
Enumeration DateOctober 24, 2007
Last NPPES UpdateApril 26, 2018
✔ NPI 1356520563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 36893
Definition
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.
3005 RIVERSIDE DR, Beloit, WI 53511
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Other Identifiers 1

Medicaid32161500WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bouc Family Wellness Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bouc Family Wellness Center, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Geoffrey Bouc, MD
Family Practice
NPI 1609947159
3005 RIVERSIDE DR SUITE 101
Beloit, WI 53511
(608) 365-7200
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bouc Family Wellness Center, LLC's NPI number?

The NPI number for Bouc Family Wellness Center, LLC is 1356520563. It was assigned to this organization in the NPPES registry on October 24, 2007.

Where is Bouc Family Wellness Center, LLC located?

Bouc Family Wellness Center, LLC is located at 3005 Riverside Dr Suite 101, Beloit, WI 53511. The listed phone number is (608) 365-7200.

What is Bouc Family Wellness Center, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Bouc Family Wellness Center, LLC enrolled in Medicare?

Yes. Bouc Family Wellness Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bouc Family Wellness Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Bouc Family Wellness Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bouc Family Wellness Center, LLC was last updated on April 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.