Active NPI
Blue Water Sleep Inc
- Home Health Registered Nurse
- Fort Gratiot, MI
National Provider Identifier
1174308290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- Legal business name
- BLUE WATER SLEEP INC
- Practice address
- 5316 Lakeshore Rd
Fort Gratiot, MI 48059-3118 - Phone
- (810) 357-8792
- NPI assigned
- Aug 28, 2023
- Last updated
- Nov 12, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jessica Heaney, NP
- Title
- Manager
- Phone
- (586) 524-5801
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 13
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Community Health Registered Nurse | 163WC1500X | |||
| Home Health Registered Nurse | 163WH0200X | Primary | ||
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Clinic/Center | 261Q00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X | |||
| Primary Care Nurse Practitioner | 363LP2300X | |||
| Home Health Clinical Nurse Specialist | 364SH0200X | |||
| Adult Companion | 372600000X | |||
| Home Health Aide | 374U00000X | |||
| Respite Care | 385H00000X |
Addresses
Primary practice location
5316 Lakeshore Rd
Fort Gratiot, MI 48059-3118
Mailing address
5316 Lakeshore Rd
Fort Gratiot, MI 48059-3118
Phone (810) 357-8792
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Port Huron, MI
- NPI 1083193783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1699747200000",
"number": "1174308290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5316 LAKESHORE RD",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593118",
"telephone_number": "810-357-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5316 LAKESHORE RD",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593118",
"telephone_number": "810-357-8792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE WATER SLEEP INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-28",
"last_updated": "2023-11-12",
"certification_date": "2023-11-11",
"status": "A",
"authorized_official_last_name": "HEANEY",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "586-524-5801",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WC1500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WH0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "364SH0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Gratiot, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.