NPIMap

Organization Active NPI

Healthstat Onsite Clinic Watertown

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Watertown, WI
National Provider Identifier
1497106900
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
HEALTHSTAT ONSITE CLINIC WATERTOWN
Practice address
111 Dodge St
Watertown, WI 53094-4434
Phone
(704) 936-5546
NPI assigned
Jun 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Warren Hutton
Title
Coo
Phone
(704) 529-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0500X Primary

Addresses

Primary practice location

111 Dodge St
Watertown, WI 53094-4434

Mailing address

4651 Charlotte Park Dr
Suite 300
Charlotte, NC 28217-1956

National Provider Directory

National Provider Directory
Tax ID family
Healthstat on-Site Clinicmilliken Kex237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

111 Dodge St
Watertown, WI 53094
Phone (920) 262-1460

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1497106900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DODGE ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944434",
            "telephone_number": "704-936-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ONSITE CLINIC WATERTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "704-529-6161"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 27, 2016; 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.