NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

  • Hospitalist Physician
  • Watertown, WI
National Provider Identifier
1760628143
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Practice address
125 Hospital Dr
Watertown, WI 53098-3303
Phone
(920) 262-4784
Fax
(920) 262-4640
NPI assigned
Jan 6, 2009
Organization subpart
Yes
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Mr. Robert J Kluge
Title
Director Patient Accounting
Phone
(920) 262-4784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

125 Hospital Dr
Watertown, WI 53098-3303

Mailing address

PO Box 684088
Chicago, IL 60695-4088
Phone (920) 262-4784

Other identifiers 1

IdentifierTypeStateIssuer
100002452MedicaidWI

Other names 1

  • UWHP WRMC Hospitalists 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": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1760628143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 684088",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606954088",
            "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": "125 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983303",
            "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": "2009-01-06",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "920-262-4784",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002452",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UWHP WRMC Hospitalists",
            "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 Mar 19, 2014; 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.