NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

Doing business as UWHP WRMC Center For Eye Care

  • Ophthalmology Physician
  • Watertown, WI
National Provider Identifier
1083943138
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Doing business as
UWHP WRMC Center For Eye Care
Practice address
123 Hospital Dr
Suite 1002
Watertown, WI 53098-3320
Phone
(920) 261-8225
Fax
(920) 261-5343
NPI assigned
Dec 21, 2009
Organization subpart
Yes
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X WI
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X WI Primary

Addresses

Primary practice location

123 Hospital Dr
Suite 1002
Watertown, WI 53098-3320

Mailing address

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 262-4784

Other identifiers 1

IdentifierTypeStateIssuer
100007049MedicaidWI

Other names 1

  • UWHP WRMC Center For Eye Care 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": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1083943138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983303",
            "telephone_number": "920-262-4784",
            "fax_number": "920-262-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "SUITE 1002",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983320",
            "telephone_number": "920-261-8225",
            "fax_number": "920-261-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2009-12-21",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR-PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "920-262-4784"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007049",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UWHP WRMC Center For Eye Care",
            "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 19, 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.