Bluewater Radiology, PLLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

BLUEWATER RADIOLOGY, PLLC

Practice address

4536 E Highway 20
Niceville, FL 32578-9755

Phone

(850) 729-6747

Fax

(850) 729-7279

NPI assigned

Nov 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ross Barnett, MDNPI 1205808755

Title

Owner

Phone

(850) 729-6747

Specialties & licenses 1

Addresses

Other names 1

• BLUEWATER DIAGNOSTIC IMAGING Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ross Barnett, M.D.

  • Diagnostic Radiology Physician
  • Montgomery, AL
  • NPI 1205808755

  Diagnostic Radiology, FL

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1073158481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242848",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242848",
            "telephone_number": "334-270-9914",
            "fax_number": "334-270-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 E HIGHWAY 20",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789755",
            "telephone_number": "850-729-6747",
            "fax_number": "850-729-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEWATER RADIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-729-6747",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUEWATER DIAGNOSTIC IMAGING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bluewater Plastic Surgery & Cosmetic Center
• Bluewater Primary Care, Inc
• Bluewater Wellness Group LLC
• Amy Elissa Bogan, BSW
• Charae Bond, RPH
• Alexis Alicia Bonton
• Boobology With Dr. Momo

• Diagnostic Radiology Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.