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UWHP WRMC LAKE MILLS CLINIC
NPI 1053590687
Family Medicine in Lake Mills, WI

Active since October 31, 2007CLIA 52D0886179 · Waiver
1025 MULBERRY ST, LAKE MILLS, WI 53551(920) 648-4518 Get Directions Write a Review

NPPES record last updated: March 19, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Uwhp Wrmc Lake Mills Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UWHP WRMC LAKE MILLS CLINIC (NPI 1053590687) is a healthcare organization registered as a family medicine in Lake Mills, Wisconsin and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through May 15, 2028 and lists Robert James Kluge, Director Patient Accounting, as its authorized official.

NPPES Registry Identity

NPI1053590687
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWATERTOWN REGIONAL MEDICAL CENTER INC
Location Address1025 MULBERRY STLake Mills, WI 53551-1304
Mailing AddressPo Box 684088Chicago, IL 60695-4088 · (920) 262-4640
Phone(920) 648-4518
Organization SubpartYes
Authorized OfficialRobert James KlugeDirector Patient Accounting · (920) 262-4784
Enumeration DateOctober 31, 2007
Last NPPES UpdateMarch 19, 2014
✔ NPI 1053590687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1025 MULBERRY ST, Lake Mills, WI 53551
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Other Names 1

Doing Business AsUwhp Wrmc Lake Mills Clinic

Other Identifiers 2

Medicaid21266900WI
Medicare PIN000030125WI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0886179

Watertown Regional Medical Center Lake Mills Clinic · Lake Mills, WI
Active · expires May 15, 2028
CLIA Number52D0886179
Laboratory TypeOff-Campus Provider Based
Certificate Effective DateMay 16, 2026
Certificate Expiration DateMay 15, 2028
Laboratory DirectorDr. Whitney Van Reesen
Laboratory Phone(920) 648-4518
Laboratory LocationWatertown Regional Medical Center Lake Mills Clinic1025 Mulberry St, Lake Mills, WI 53551
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LYNNE M. EDEBOHLS APNP
Nurse Practitioner (Pediatrics)
1025 MULBERRY ST
LAKE MILLS, WI 53551
Jefferson County (920) 648-4518
KATHERINE A LOTHE NP
Nurse Practitioner
1025 MULBERRY ST
LAKE MILLS, WI 53551
Jefferson County (920) 648-4518
WHITNEY MARIE VAN REESEN M.D.
Family Medicine
1025 MULBERRY ST
LAKE MILLS, WI 53551
Jefferson County (920) 648-1451
ROCK RIVER FOOT & ANKLE CLINIC, SC
Podiatrist (Foot & Ankle Surgery)
1025 MULBERRY ST
LAKE MILLS, WI 53551
Jefferson County (920) 261-9591

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Watertown Regional Medical Center Inc's NPI number?

The NPI number for Watertown Regional Medical Center Inc is 1053590687. It was assigned to this organization in the NPPES registry on October 31, 2007. The provider is doing business as Uwhp Wrmc Lake Mills Clinic.

Where is Watertown Regional Medical Center Inc located?

Watertown Regional Medical Center Inc is located at 1025 Mulberry St, Lake Mills, WI 53551. The listed phone number is (920) 648-4518.

What is Watertown Regional Medical Center Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Watertown Regional Medical Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0886179) is associated with this NPI, valid through May 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Watertown Regional Medical Center Inc was last updated on March 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.