NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

  • Plastic Surgery Physician
  • Watertown, WI
National Provider Identifier
1043593916
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Doing business as
UWHP WRMC Bellissa
Practice address
123 Hospital Dr
Ste 2003
Watertown, WI 53098-3331
Phone
(920) 262-4577
Fax
(920) 262-4578
NPI assigned
Sep 27, 2011
Organization subpart
Yes
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Robert James Kluge
Title
Director- Patient Accounting
Phone
(920) 262-4784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

123 Hospital Dr
Ste 2003
Watertown, WI 53098-3331

Mailing address

PO Box 684088
Chicago, IL 60695-4088
Phone (920) 262-4784

Other identifiers 1

IdentifierTypeStateIssuer
100018161MedicaidWI

Other names 1

  • UWHP WRMC Bellissa Doing business as

National Provider Directory

National Provider Directory
Part of
Watertown Medmorial HSP

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1043593916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 684088",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606954088",
            "telephone_number": "920-262-4784",
            "fax_number": "920-262-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "STE 2003",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983331",
            "telephone_number": "920-262-4577",
            "fax_number": "920-262-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2011-09-27",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR- PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "920-262-4784"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100018161",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UWHP WRMC Bellissa",
            "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 Mar 25, 2014; 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.