Active NPI
Watertown Regional Medical Center, Inc
- Home Health Agency
- Watertown, WI
National Provider Identifier
1972505154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 165
- Legal business name
- WATERTOWN REGIONAL MEDICAL CENTER, INC
- Practice address
- 125 Hospital Dr
Watertown, WI 53098-3303 - Phone
- (920) 261-4210
- NPI assigned
- Jun 1, 2005
- Organization subpart
- Yes
- Parent organization
- WATERTOWN REGIONAL MEDICAL CENTER, INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 165 | WI | Primary |
Addresses
Primary practice location
125 Hospital Dr
Watertown, WI 53098-3303
Mailing address
125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 262-4784
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41514400 | Medicaid | WI | |
| A9 | Other | WI | DEAN CARE PROVIDER # |
| 1020802 | Other | WI | PHY PLUS |
Other names 1
- UW HEALTH PARTNERS WATERTOWN REGIONAL MEDICAL CENTER HOME HEALTH
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": "1117584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317254400000",
"number": "1972505154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"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"
},
{
"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": "920-261-4210"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
"enumeration_date": "2005-06-01",
"last_updated": "2011-09-29",
"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": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WI",
"license": "165",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41514400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN CARE PROVIDER #",
"identifier": "A9",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHY PLUS",
"identifier": "1020802",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "UW HEALTH PARTNERS WATERTOWN REGIONAL MEDICAL CENTER HOME HEALTH",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Watertown, WI
- Watertown Regional Medical Center, Inc
- Watertown Regional Medical Center, Inc
- Watertown Regional Medical Center, Inc
- Watertown Regional Medical Center, Inc
- Watertown Regional Medical Center, Inc
- Watertown Unified School District
- Watertown Urology, S.C.
- Watertown Vision, LLC
- Jessica Ann Waterworth, DC
- Rachel Weeden, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.