NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

Doing business as WRMC Urgent Care Physicians

  • Physician Assistant
  • Watertown, WI
National Provider Identifier
1770861965
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Doing business as
WRMC Urgent Care Physicians
Practice address
125 Hospital Dr
Suite 2004
Watertown, WI 53098-3303
Phone
(920) 262-4222
NPI assigned
Jul 22, 2011
Last updated
Mar 25, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Robert James Kluge
Title
Director-Patient Accounting
Phone
(920) 262-4784

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X WI Primary
Nurse Practitioner 363L00000X WI

Addresses

Primary practice location

125 Hospital Dr
Suite 2004
Watertown, WI 53098-3303

Mailing address

PO Box 684088
Chicago, IL 60695-4088
Phone (920) 262-4422

Other identifiers 1

IdentifierTypeStateIssuer
100016949MedicaidWI

Other names 1

  • WRMC Urgent Care Physicians Doing business as

National Provider Directory

National Provider Directory
Part of
Watertown Medmorial HSP

Locations

125 Hospital Dr
Ste 2004
Watertown, WI 53098
Phone (920) 262-4222

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1770861965",
    "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": "920-262-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HOSPITAL DR",
            "address_2": "SUITE 2004",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983303",
            "telephone_number": "920-262-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2011-07-22",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR-PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "920-262-4784"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100016949",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WRMC Urgent Care Physicians",
            "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 25, 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.