NPIMap

Organization Active NPI

Watertown Regional Medical Center, Inc

Doing business as UWHP WRMC Hospital Drive Clinic

  • Internal Medicine Physician
  • Watertown, WI
National Provider Identifier
1770885683
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER, INC
Doing business as
UWHP WRMC Hospital Drive Clinic
Practice address
123 Hospital Dr
Ste 2009
Watertown, WI 53098-3320
Phone
(920) 206-9833
Fax
(920) 262-9834
NPI assigned
Nov 29, 2010
Last updated
Mar 20, 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 20, 2014

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X WI Primary

Addresses

Primary practice location

123 Hospital Dr
Ste 2009
Watertown, WI 53098-3320

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100012742MedicaidWI

Other names 1

  • UWHP WRMC Hospital Drive Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Directions Counseling C

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1770885683",
    "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": "123 HOSPITAL DR",
            "address_2": "STE 2009",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983320",
            "telephone_number": "920-206-9833",
            "fax_number": "920-262-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "enumeration_date": "2010-11-29",
        "last_updated": "2014-03-20",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100012742",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UWHP WRMC Hospital Drive Clinic",
            "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 20, 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.