WRMC JEFFERSON PT CLINIC
NPI 1205223518
Physical Medicine & Rehabilitation - Sports Medicine in Jefferson, WI
NPI Status: Active since April 24, 2015
Contact Information
621 W RACINE ST
JEFFERSON, WI
ZIP 53549
Phone: (920) 541-3513
- Organization
- Physical Medicine & Rehabilitation
- Sports Medicine
- CLIA Number: 52D0388938
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-20-2026
About WRMC JEFFERSON PT CLINIC
This page provides the complete NPI Profile along with additional information for Wrmc Jefferson Pt Clinic, a provider established in Jefferson, Wisconsin operating as a Physical Medicine & Rehabilitation, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1205223518 assigned on April 2015. The practitioner's primary taxonomy code is 2081S0010X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Wrmc Jefferson Pt Clinic. The authorized official of this NPI record is Robert James Kluge (Director Patient Accounting)
- NPI
- 1205223518
- Provider Legal Name
- WATERTOWN REGIONAL MEDICAL CENTER, INC
- Other Organization Name
- WRMC JEFFERSON PT CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 621 W RACINE ST JEFFERSON, WI 53549
- Location Phone
- (920) 541-3513
- Mailing Address
- 125 HOSPITAL DR WATERTOWN, WI 53098
- Mailing Phone
- (920) 262-4784
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-24-2015
- Last Update Date
- 04-24-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Medicine & Rehabilitation Sports Medicine
- Taxonomy Code
- 2081S0010X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0388938
- Facility Type
- Physician Office
- Certificate Effective Date
- January 21, 2024
- Certificate Expiration Date
- January 20, 2026
- Laboratory Director
- DR. JOHN BASARICH
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Wrmc Jefferson Pt Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 0 | 5 | 2 | 2 | 3 | 5 | 1 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 4 | 2 | 6 | 5 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 4 + 2 + 6 + 5 + 2 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1205223518 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053508978 | XCEL PHYSICAL THERAPY, INC. Organization | Clinic/Center (Physical Therapy) | 621 W RACINE ST JEFFERSON, WI 53549 (608) 279-6960 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205223518, enumerated in the NPI registry as an "organization" on April 24, 2015
The provider is located at 621 W Racine St Jefferson, Wi 53549 and the phone number is (920) 541-3513
This medical organization specializes in Physical Medicine & Rehabilitation with taxonomy code 2081S0010X with a focus in Sports Medicine
The provider's CLIA number is 52D0388938 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on April 24, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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