Active NPI
Tim M Nordwig, RN
- Registered Nurse
- Watertown, WI
National Provider Identifier
1851351654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 60954
- Practice address
- 609 Labaree St
Watertown, WI 53098-3019 - Phone
- (920) 262-9499
- NPI assigned
- Mar 24, 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 60954 | WI | Primary |
Addresses
Primary practice location
609 Labaree St
Watertown, WI 53098-3019
Mailing address
609 Labaree St
Watertown, WI 53098-3019
Phone (920) 262-9499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39818100 | 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)
- Not enrolled
- Credentials
- Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1851351654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 LABAREE ST",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983019",
"telephone_number": "920-262-9499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 LABAREE ST",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983019",
"telephone_number": "920-262-9499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDWIG",
"first_name": "TIM",
"middle_name": "M",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "60954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39818100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, WI
- Elizabeth Alice Nelson, PA-C
- Angela Marie Newman, PA-C
- Thuan Van Ngo, DPT
- Toby Scott Nicholson, A.T.C.
- Jody Nordby, PHARMD
- Normic Enterprises Inc (My Place of Watertown)
- North Star Chiropractic LLC
- Kathleen M O Neill, MSW LCSW
- Kevin L O'Halloran, MD
- Oak Ridge Dental Clinic,SC (Associated Dentists of Watertown)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.