NPIMap

Organization Active NPI

Watertown Physician Practices LLC

Doing business as Watertown Medical Clinic

  • Family Medicine Physician
  • Watertown, WI
National Provider Identifier
1003383027
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WATERTOWN PHYSICIAN PRACTICES LLC
Doing business as
Watertown Medical Clinic
Practice address
132 Hospital Dr
Watertown, WI 53098-3304
Phone
(920) 261-2020
Fax
(920) 261-0457
NPI assigned
Oct 29, 2018
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Charlotte L
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

132 Hospital Dr
Watertown, WI 53098-3304

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Watertown Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150626000114 WI Part B Supplier - Clinic/Group Practice 8022329408 Receives reassigned benefits from 238 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Juneau, WI; Watertown, WI; Waterloo, WI; Lake Mills, WI; Johnson Creek, WI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

123 Hospital Dr
Ste 2006
Watertown, WI 53098
Phone (920) 261-1334

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1003383027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983304",
            "telephone_number": "920-261-2020",
            "fax_number": "920-261-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "L",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watertown Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Watertown Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.