OrganizationActive
Watertown Physician Practices LLC
NPI 1699315366 · Family Medicine Physician · Watertown, WI
Provider details
- NPI number
- 1699315366
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Johnetta Traylor, Ao(502) 596-6063
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
111 Dodge St
Watertown, WI 53094-4434
Phone: (920) 262-1460
Street-level locationGet directions
Mailing address
680 S 4th St
Louisville, KY 40202-2407
Registry dates
- Enumerated
- 2020-01-10
- Last updated
- 2025-06-26
- Certified
- 2025-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.