Blue Water Eye Care Associates PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

BLUE WATER EYE CARE ASSOCIATES PC

Practice address

2609 Electric Ave
Suite a
Port Huron, MI 48060-6589

Phone

(810) 982-1300

Fax

(810) 982-9802

NPI assigned

Jul 22, 2008

Organization subpart

No

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

Authorized official

Name

Katy S Brochu

Title

Billing

Phone

(810) 982-1300

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Carol Allen, OD

  • Optometrist
  • Fort Gratiot, MI
  • NPI 1902941537
  Medicare reassignment NPD
• Kevin D Johnson, M.D.

  • Ophthalmology Physician
  • Port Huron, MI
  • NPI 1184721599
  Medicare reassignment NPD

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1104081819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 ELECTRIC AVE",
            "address_2": "SUITE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606589",
            "telephone_number": "810-982-1300",
            "fax_number": "810-982-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 ELECTRIC AVE",
            "address_2": "SUITE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606589",
            "telephone_number": "810-982-1300",
            "fax_number": "810-982-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER EYE CARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "BROCHU",
        "authorized_official_first_name": "KATY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "810-982-1300"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevinj@bluewater.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2609 Electric Ave",
            "address_2": "Suite A",
            "city": "Port Huron",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480606589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeanette Joy Bloink, RN
• Blue Water ASC LLC
• Blue Water Center for Christian Counseling P.C.
• Blue Water Center for Independent Living
• Blue Water Dental Group Port Huron P.C.
• Blue Water Internal Medicine, PC
• Blue Water Medical Massage PLLC
• Blue Water Medical PLLC
• Blue Water OB & GYN PC
• Blue Water Oncology PC

• Ophthalmology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.