DR. TERRY MARK ROMAN (NPI# 1083895312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083895312 |
| Entity Type | Individual |
| Full Name | DR. TERRY MARK ROMAN |
| Credential | D.O. |
| Practice Address |
123 Hospital Dr Suite 1008 Watertown WI 53098-3331 |
| Practice Telephone | 9202066500 |
| Practice Fax Number | 9202614013 |
| Mailing Telephone | 9202066500 |
| Mailing Fax Number | 9202614013 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2013-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
54555-021 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1083895312 | 05 |
| Street Address |
123 HOSPITAL DR SUITE 1008 |
| 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 |
| 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 |
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| 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 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346725157 | Scott William Niel Mollison | Orthopaedic Surgery | 1571 Washington St Ste 201, Watertown, NY 13601-9304 | 2018-09-27 |
| 1376749887 | Edward Choung | Orthopaedic Surgery | 1571 Washington St, Suite 201, Watertown, NY 13601-9304 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144464199 | Lyall Carlton Stilp II | Orthopaedic Surgery | 2133 Willow Ln, Oshkosh, WI 54902-9121 | 2009-04-21 |
| 1992953921 | William David Jones | Orthopaedic Surgery | 1554 River Pines Dr, Green Bay, WI 54311-5648 | 2008-09-03 |
| 1588639256 | Albert J Cecchini | Orthopaedic Surgery | 3119 Woodman Dr, Altoona, WI 54720-2668 | 2006-02-17 |
| 1811992886 | Tamara A Scerpella | Orthopaedic Surgery | 621 Science Dr, Madison, WI 53711-1074 | 2005-06-16 |
| 1538716725 | Jessica Lynn Flood | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-08-22 |
| 1154883593 | Kristin K. Lietzau | Orthopaedic Surgery | Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 | 2019-04-04 |
| 1154839140 | Sandra Koester | Orthopaedic Surgery | 1111 Delafield St, Waukesha, WI 53188 | 2018-01-12 |
| 1750736120 | Orthopaedic Centers of Wisconsin, S.c. | Orthopaedic Surgery | 500 Vincent St, Stevens Point, WI 54481-1842 | 2016-05-04 |
| 1740549773 | Community Health Network Inc | Orthopaedic Surgery | 191 Memorial Dr, Berlin, WI 54923-1241 | 2012-05-11 |
| 1922322429 | Andrea M. Spiker | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2010-03-26 |
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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.