Active NPI
Frederick C Gremmels, D.O.
- Family Medicine Physician
- Watertown, WI
National Provider Identifier
1720156896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20398
- Practice address
- 127 Hospital Dr
Watertown, WI 53098-3303 - Phone
- (920) 261-8500
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20398 | WI | Primary |
Addresses
Primary practice location
127 Hospital Dr
Watertown, WI 53098-3303
Mailing address
1517 Country Club LN
Watertown, WI 53098-4349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30036200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720156896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1517 COUNTRY CLUB LN",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530984349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 HOSPITAL DR",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983303",
"telephone_number": "920-261-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREMMELS",
"first_name": "FREDERICK",
"middle_name": "C",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "20398",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30036200",
"state": "WI"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.