Watertower Pain Consultants, SC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WATERTOWER PAIN CONSULTANTS, SC

Practice address

575 W River Woods Pkwy
#205
Glendale, WI 53212-1003

Phone

(414) 962-6700

NPI assigned

Mar 9, 2006

Organization subpart

No

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

Authorized official

Name

Stephen Donatello, MD

Title

President

Phone

(414) 962-6700

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1053389544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W RIVER WOODS PKWY",
            "address_2": "#205",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W RIVER WOODS PKWY",
            "address_2": "#205",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121003",
            "telephone_number": "414-962-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWER PAIN CONSULTANTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "DONATELLO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-962-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21298700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "52D1088766",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Joyce Ward, MSW, APSW, SSW
• Mary D Washburne, MD
• Sandra A Washer, MS CCC SLP
• Jennifer Washington
• George Alistair Wasielewski
• Sephora Abigail Wawa Egbuche
• Anne Zarb Weber, D.D.S.
• Caitlin Weber, MS, LMFT
• Heidi Elizabeth Bares Weidner, PT
• Robert L. Welker, PHD

• Pain Medicine (Anesthesiology) Physician in Glendale, WI
• Providers in Glendale, WI by specialty
• Pain Medicine (Anesthesiology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.