NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

  • Medical Physician Assistant
  • Watertown, WI
National Provider Identifier
1245489897
Registry record updated Sep 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Doing business as
UW Health Partners Watertown Regional Medical Center Fast Care Clinic
Practice address
701 S Church St
Watertown, WI 53094-6213
Phone
(920) 262-4784
Fax
(920) 262-4640
NPI assigned
Sep 18, 2008
Organization subpart
Yes
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2010

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

Authorized official

Name
Robert J Kluge
Title
Patient Financial Services Manager
Phone
(920) 262-4784

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

701 S Church St
Watertown, WI 53094-6213

Mailing address

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

Other names 1

  • UW Health Partners Watertown Regional Medical Center Fast Care Clinic 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": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284163200000",
    "number": "1245489897",
    "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": "920-262-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946213",
            "telephone_number": "920-262-4784",
            "fax_number": "920-262-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2008-09-18",
        "last_updated": "2010-09-11",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PATIENT FINANCIAL SERVICES MANAGER",
        "authorized_official_telephone_number": "920-262-4784"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Health Partners Watertown Regional Medical Center Fast Care 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 Sep 11, 2010; 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.