WATERTOWN PHYSICIAN PRACTICES LLC (NPI# 1770964363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770964363 |
| Entity Type | Organization |
| Organization Name | WATERTOWN PHYSICIAN PRACTICES LLC |
| Practice Address |
1507 Doctors Ct Watertown WI 53094-4101 |
| Practice Telephone | 9202614111 |
| Practice Fax Number | 9202618387 |
| Mailing Telephone | 9202614111 |
| Mailing Fax Number | 9202618387 |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2018-05-09 |
| Authorized Official Name | SARA L MILLER (DIRECTOR) |
| Authorized Official Telephone | 6159207514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1528558749 | Watertown Physician Practices LLC | Eyewear Supplier (Equipment, not the service) | 123 Hospital Dr Ste 2005, Watertown, WI 53098 | 2018-05-14 |
| 1699315366 | Watertown Physician Practices LLC | General Practice | 111 Dodge St, Watertown, WI 53094-4434 | 2020-01-10 |
| 1003383027 | Watertown Physician Practices LLC | Physician Assistant | 132 Hospital Dr, Watertown, WI 53098-3304 | 2018-10-29 |
| 1225412265 | Watertown Physician Practices LLC | Internal Medicine | 125 Hospital Dr, Watertown, WI 53098-3303 | 2015-07-18 |
| 1760866891 | Watertown Physician Practices LLC | Counselor | 129 Hospital Dr, Watertown, WI 53098-3334 | 2015-07-18 |
| 1407230238 | Watertown Physician Practices LLC | Nurse Anesthetist, Certified Registered | 125 Hospital Dr, Watertown, WI 53098-3303 | 2015-07-10 |
| Street Address |
1507 DOCTORS CT |
| City | WATERTOWN |
| State | WI |
| Zip Code | 53094-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003882788 | Sarah J Barnett | Physician Assistant | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2006-02-23 |
| 1881244358 | Amber Rose Hendriksen | Nurse Practitioner | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2019-09-17 |
| 1578747580 | Watertown Regional Medical Center Inc | Family Medicine | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2007-12-27 |
| 1770663221 | Family Medical Clinic, S.c. | Family Medicine | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2006-10-17 |
| 1801992607 | Family Medical Clinic, S.c. | Family Medicine | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2006-09-16 |
| 1023085685 | Michael A Grajewski | Family Medicine | 1507 Doctors Ct, Watertown, WI 53094-4101 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025371 | Addie Marie Littrell | Pharmacist | 624 S Church Street, Pharmacy Department, Watertown, WI 53094 | 2020-02-13 |
| 1144788274 | Robert Scott Johnson | Dentist | 314 W. Main St., Watertown, WI 53094 | 2019-03-07 |
| 1043785264 | Christian Long | Physical Therapist | Watertown Regional Medical Center, 1684 S Church St, Watertown, WI 53094 | 2018-10-04 |
| 1558566497 | Georgia E Meyer | Occupational Therapist | Rahab In Motion, 615 East Main St Suite B, Watertown, WI 53094 | 2007-06-20 |
| 1588789036 | Kjm Enterprises Inc | Home Health | 111 N Third Street, Watertown, WI 53094 | 2007-03-20 |
| 1114085412 | Paul R Sommers Dds Sc | Dentist | 121 Oakridge Court, Watertown, WI 53094 | 2006-12-05 |
| 1063593614 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 622 S Church St, Watertown, WI 53094 | 2006-10-18 |
| 1598851800 | David J Groh | Dentist | 1521 Doctors Ct, Watertown, WI 53094 | 2006-10-05 |
| 1861594251 | Robert Delano Heinen | General Practice | 700 Hoffmann Dr, Bethesda Lutheran Homes and Services, Watertown, WI 53094 | 2006-09-05 |
| 1669483897 | Donald Alan Wollheim | Surgery | 1911 Gateway Drive, Watertown, WI 53094 | 2006-08-11 |
| Find all providers in zip 53094 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871710095 | Mary Jane Moran Brackett | Family Medicine | 45 Litchfield Rd, Watertown, CT 06795-1944 | 2007-04-19 |
| 1215058367 | Rosemary E Pomponio | Family Medicine | 376 Arsenal St, Watertown, MA 02472-2892 | 2007-04-03 |
| 1932232378 | Primary Health of Northern New York, Pllc | Family Medicine | 156 Clinton St, Watertown, NY 13601-3602 | 2007-03-14 |
| 1649359209 | Heidi R Wuerger | Family Medicine | 309 Jefferson Ave Sw, Watertown, MN 55388-8101 | 2006-11-03 |
| 1427071125 | Robert John Kasulke | Family Medicine | 270 Clinton St, Watertown, NY 13601-3620 | 2006-07-25 |
| 1992758270 | Jason F. White | Family Medicine | 53-59 Public Square Suite 301, Watertown Internists, PC, Watertown, NY 13601 | 2006-05-18 |
| 1679521132 | Joseph Wetterhahn | Family Medicine | 1575 Washington St, Watertown, NY 13601-9367 | 2006-05-05 |
| 1154305662 | Scott M Jensen | Family Medicine | 204 Lewis Ave S Ste 201, Watertown, MN 55388-4502 | 2005-11-30 |
| 1790768364 | William Curtis Whisler | Family Medicine | 204 Lewis Ave S, Suite 200, Watertown, MN 55388-4500 | 2005-11-28 |
| 1013908771 | Robert Steven Legrow | Family Medicine | 127 Hospital Dr, Watertown, WI 53098-3303 | 2005-11-02 |
| Find all providers in WATERTOWN | ||||
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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.