Waters Preventive Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

27520 Issued in WI

Legal business name

WATERS PREVENTIVE MEDICAL CENTER

Doing business as

Waters Integrative Health Center

Practice address

320 Race St
Wisconsin Dells, WI 53965-1822

Phone

(608) 254-7178

Fax

(608) 253-7139

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Scott Waters, M.D.NPI 1194948133

Title

Owner

Phone

(608) 254-7178

Specialties & licenses 1

Addresses

Other names 1

• Waters Integrative Health Center Doing business as

Locations

Practitioners 1

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.

• Robert Scott Waters, M.D.

  • General Practice Physician
  • Wisconsin Dells, WI
  • NPI 1194948133
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306069364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "WISCONSIN DELLS",
            "state": "WI",
            "postal_code": "539650357",
            "telephone_number": "608-254-7178",
            "fax_number": "608-253-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RACE ST",
            "city": "WISCONSIN DELLS",
            "state": "WI",
            "postal_code": "539651822",
            "telephone_number": "608-254-7178",
            "fax_number": "608-253-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS PREVENTIVE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-254-7178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "27520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waters Integrative Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-3505)
• Wal-Mart Stores East, LP (Vision Center 30-3505)
• Walgreen Co (Walgreens #06885)
• Jacquelyn Marie Walker, P.T.
• Thomas Robert Warwick
• Robert Scott Waters, M.D.
• Paula Marie Weiss, OTR
• Richard K Westphal, MD

• Clinic/Center in Wisconsin Dells, WI
• Providers in Wisconsin Dells, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.