WATERTOWN REGIONAL MEDICAL CENTER, INC (NPI# 1043593916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043593916 |
| Entity Type | Organization |
| Organization Name | WATERTOWN REGIONAL MEDICAL CENTER, INC |
| Other Organization Name | UWHP WRMC BELLISSA |
| Practice Address |
123 Hospital Dr Ste 2003 Watertown WI 53098-3331 |
| Mailing Address |
Po Box 684088 Chicago IL 60695-4088 |
| Practice Telephone | 9202624577 |
| Practice Fax Number | 9202624578 |
| Mailing Telephone | 9202624784 |
| Mailing Fax Number | 9202624640 |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2014-03-25 |
| Authorized Official Name | ROBERT JAMES KLUGE (DIRECTOR- PATIENT ACCOUNTING) |
| Authorized Official Telephone | 9202624784 |
| Is Organization Subpart | Y |
| Parent Organization Name | WATERTOWN REGIONAL MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100018161 | 05 |
| Other Name | Type Code |
|---|---|
| UWHP WRMC Bellissa | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407035033 | Watertown Regional Medical Center, Inc | Clinic/Center | 700 Hoffman Dr, Watertown, WI 53094-6204 | 2007-10-31 |
| 1972505154 | Watertown Regional Medical Center, Inc | Home Health | 125 Hospital Dr, Watertown, WI 53098-3303 | 2005-06-01 |
| 1205223518 | Watertown Regional Medical Center, Inc | Physical Medicine & Rehabilitation | 621 W Racine St, Jefferson, WI 53549-1048 | 2015-04-24 |
| 1659796878 | Watertown Regional Medical Center, Inc | Family Medicine | 125 Hospital Dr, Watertown, WI 53098-3303 | 2014-02-25 |
| 1770914384 | Watertown Regional Medical Center, Inc | Family Medicine | W359n5002 Brown St, Ste 208, Oconomowoc, WI 53066-3366 | 2013-12-06 |
| 1750727723 | Watertown Regional Medical Center, Inc | Family Medicine | W359n5002 Brown St, 208, Oconomowoc, WI 53066-3366 | 2013-05-17 |
| 1194072660 | Watertown Regional Medical Center, Inc | Otolaryngology | 123 Hospital Dr, Ste 2002, Watertown, WI 53098-3320 | 2012-08-14 |
| 1629346028 | Watertown Regional Medical Center, Inc | Plastic Surgery | W359n5002 Brown St, Suite 208, Oconomowoc, WI 53066-3366 | 2011-12-13 |
| 1356627699 | Watertown Regional Medical Center, Inc | Family Medicine | 123 Hospital Dr, Ste 2004, Watertown, WI 53098-3331 | 2011-11-01 |
| 1013296391 | Watertown Regional Medical Center, Inc | Physician Assistant | 123 Hospital Dr, Ste 2004, Watertown, WI 53098-3336 | 2011-08-04 |
| Street Address |
123 HOSPITAL DR STE 2003 |
| City | WATERTOWN |
| State | WI |
| Zip Code | 53098-3331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053314070 | George Andrew Boush | Ophthalmology | 123 Hospital Dr, Suite 1002, Watertown, WI 53098-3331 | 2005-05-23 |
| 1144600511 | Jillian Stevens | Hearing Instrument Specialist | 123 Hospital Dr, Ste 112, Watertown, WI 53098-3331 | 2015-06-01 |
| 1487053005 | Casey Jo Brown | Nurse Practitioner | 123 Hospital Dr, Suite 2009, Watertown, WI 53098-3331 | 2014-08-19 |
| 1710395058 | Promporn June Suwanabol | Physician Assistant | 123 Hospital Dr, Suite 2009, Watertown, WI 53098-3331 | 2014-07-30 |
| 1912319575 | Connect Hearing, Inc. | Audiologist | 123 Hospital Dr, Ste 112, Watertown, WI 53098-3331 | 2014-05-29 |
| 1194072660 | Watertown Regional Medical Center, Inc | Otolaryngology | 123 Hospital Dr, Ste 2002, Watertown, WI 53098-3320 | 2012-08-14 |
| 1043586068 | Hearing Center, Inc. | Audiologist | 123 Hospital Dr, Ste 112, Watertown, WI 53098-3320 | 2012-03-23 |
| 1356627699 | Watertown Regional Medical Center, Inc | Family Medicine | 123 Hospital Dr, Ste 2004, Watertown, WI 53098-3331 | 2011-11-01 |
| 1013296391 | Watertown Regional Medical Center, Inc | Physician Assistant | 123 Hospital Dr, Ste 2004, Watertown, WI 53098-3336 | 2011-08-04 |
| 1982982351 | Gordon Roy Marsden | Physician Assistant | 123 Hospital Dr, Suite 2006, Watertown, WI 53098-3331 | 2011-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528558749 | Watertown Physician Practices LLC | Eyewear Supplier (Equipment, not the service) | 123 Hospital Dr Ste 2005, Watertown, WI 53098 | 2018-05-14 |
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1598045692 | Bonnie Kay Peot | Licensed Practical Nurse | 1420 Wedgewood Drive, Watertown, WI 53098 | 2011-08-19 |
| 1275790404 | Kathy R. Adkins | Physical Therapy Assistant | 1020 Hill Street, Watertown, WI 53098 | 2008-05-16 |
| 1336361294 | Patrice Walter | Occupational Therapist | 125 Hospital Dr., Watertown, WI 53098 | 2007-05-02 |
| 1720161284 | Carolyn T Schneider-donley | Optometrist | 622 N. Church Street, Watertown, WI 53098 | 2006-10-20 |
| 1730156431 | Mohamed H Yafai | Internal Medicine | 123 Hospital Drive, Suite 2009, Watertown, WI 53098 | 2006-03-02 |
| 1093711236 | Dana M. Fields | Physician Assistant | 134 Hospital Drive, Watertown, WI 53098 | 2005-06-22 |
| 1528560018 | Watertown Medical Center LLC | Psychiatric Unit | 125 Hospital Drive, Watertown, WI 53098 | 2018-03-01 |
| 1437544863 | Zachary Richardson | Internal Medicine | 125 Hospital Dr, Watertown, WI 53098 | 2015-04-02 |
| Find all providers in zip 53098 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1508122938 | Stephanie Suprenant | Plastic Surgery | Uw Hospital and Clinics 600 Highland Ave, H4/831, Madison, WI 53792-0001 | 2012-04-10 |
| 1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
| 1114198660 | Ruedi Peter Gingrass | Plastic Surgery | 7130 Wellauer Dr, Wauwatosa, WI 53213-3767 | 2008-03-12 |
| 1669695284 | Fox Valley Plastic Surgery, S.c. | Plastic Surgery | 2400 Witzel Ave, Suite A, Oshkosh, WI 54904-8369 | 2007-04-11 |
| 1528105897 | Alex Colque | Plastic Surgery | 21675 E. Moreland Blvd., Suite 100, Waukesha, WI 53186-2906 | 2007-01-30 |
| 1447313747 | Kevin M. Robertson | Plastic Surgery | 3205 Glacier Ridge Rd, Middleton, WI 53562-1765 | 2006-12-18 |
| 1568532521 | Maida Ann Parkins | Plastic Surgery | W307 N1497 Golf Rd, Suite 200, Delafield, WI 53018 | 2006-11-08 |
| 1720183130 | Michelle R Bonness | Plastic Surgery | 20320 W Greenfield Ave, Brookfield, WI 53045-3737 | 2006-09-13 |
| 1831116797 | Steven C Schmidt | Plastic Surgery | 2605 Development Dr, Green Bay, WI 54311-4240 | 2006-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.