WATERTOWN REGIONAL MEDICAL CENTER, INC (NPI# 1194072660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194072660 |
| Entity Type | Organization |
| Organization Name | WATERTOWN REGIONAL MEDICAL CENTER, INC |
| Other Organization Name | UWHP WRMC ENT CENTER |
| Practice Address |
123 Hospital Dr Ste 2002 Watertown WI 53098-3320 |
| Mailing Address |
Po Box 684088 Chicago IL 60695-4088 |
| Practice Telephone | 9202624460 |
| Practice Fax Number | 9202624533 |
| Mailing Telephone | 9202624784 |
| Mailing Fax Number | 9202624640 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2014-03-19 |
| Authorized Official Name | MR. 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 | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100024938 | 05 |
| Other Name | Type Code |
|---|---|
| UWHP WRMC ENT CENTER | 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 |
| 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 |
| 1043593916 | Watertown Regional Medical Center, Inc | Plastic Surgery | 123 Hospital Dr, Ste 2003, Watertown, WI 53098-3331 | 2011-09-27 |
| 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 2002 |
| City | WATERTOWN |
| State | WI |
| Zip Code | 53098-3320 |
| 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 |
| 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 |
| 1043593916 | Watertown Regional Medical Center, Inc | Plastic Surgery | 123 Hospital Dr, Ste 2003, Watertown, WI 53098-3331 | 2011-09-27 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1407948011 | Watertown Ear Nose and Throat Grp | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4064 | 2006-09-29 |
| 1811006786 | Albert A. Mcclain Jr. | Otolaryngology | 830 Washington St, Watertown, NY 13601-4034 | 2006-08-30 |
| 1972525962 | Sanford Clinic | Otolaryngology | 600 4th St Ne, Suite 101, Watertown, SD 57201-1898 | 2006-07-25 |
| 1033147772 | Norman Weir | Otolaryngology | 826 Washington St, Watertown, NY 13601-4063 | 2006-06-29 |
| 1790736890 | Tony C.y. Chuang | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2006-05-13 |
| 1932177862 | Central Otologic Ltd | Otolaryngology | 123 Hospital Drive, Ste 106, Watertown, WI 53098 | 2006-03-08 |
| 1033105309 | Braxton L Hillerman | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| 1144216359 | William I Forbes IIi | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104156 | Alliance Ent and Hearing Center, Sc | Otolaryngology | 2524 E Webster Place, Suite 201, Milwaukee, WI 53211-4257 | 2020-11-04 |
| 1962969915 | Alliance Ent & Hearing Center, S.c. | Otolaryngology | 2500 W Layton Ave Ste 230, Milwaukee, WI 53221-5421 | 2019-02-26 |
| 1184010977 | Chad Michael Ennis | Otolaryngology | 1 S Park St Fl 6, Madison, WI 53715-1375 | 2015-04-08 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1760803795 | Gary Miller | Otolaryngology | 3467 Northwood Rd, Suamico, WI 54313-8250 | 2013-12-17 |
| 1629320007 | Peter Uy Lee | Otolaryngology | 1341 Boundary Rd, Middleton, WI 53562-3843 | 2012-10-09 |
| 1700145091 | Kenneth Brian Lewoczko | Otolaryngology | 600 Highland Ave., H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2012-05-08 |
| 1962768267 | Christopher Joseph Lee | Otolaryngology | 500 W. Drexel Ave, Suite 300, Oak Creek, WI 53154-2060 | 2012-04-11 |
| 1871814715 | Norval Eldred Bernhardt | Otolaryngology | 9 Holt Ct, Madison, WI 53719-3036 | 2010-06-15 |
| 1114248028 | Colleen Plein | Otolaryngology | 6127 Green Bay Rd Ste 100, Kenosha, WI 53142-2941 | 2010-06-15 |
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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.