Watershed Urology, P.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD050185L Issued in PA

Legal business name

WATERSHED UROLOGY, P.C.

Practice address

9 Brookwood Ave
Carlisle, PA 17015-9126

Phone

(717) 241-2200

Fax

(717) 245-9611

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce V. Gronkiewicz, M.D.

Title

Physician

Phone

(717) 241-2200

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1467578732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BROOKWOOD AVE",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170159126",
            "telephone_number": "717-241-2200",
            "fax_number": "717-245-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BROOKWOOD AVE",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170159126",
            "telephone_number": "717-241-2200",
            "fax_number": "717-245-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED UROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "GRONKIEWICZ",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "717-241-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "PA",
            "license": "MD050185L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB4793",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Reed Warner, PTA
• Dina Marie Washburn, PHARMD
• Catherine Washko
• Tonya Wasielewski
• Stephanie Renee Waters, MD
• Anna Watts
• Wayfinder Services
• Amy Beth Weaver, COTA/L
• Jeannie Weaver
• Donna C Weer, CRNFA

• Urology Physician in Carlisle, PA
• Providers in Carlisle, PA by specialty
• Urology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.