Blue Water Ear Nose and Throat, P.a.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

BLUE WATER EAR NOSE AND THROAT, P.A.

Practice address

4917 S Croatan Hwy Ste 1C
Nags Head, NC 27959-8996

Phone

(252) 489-4682

NPI assigned

Jun 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Marci Ellen Lait, MDNPI 1649258617

Title

Physician

Phone

(252) 489-4682

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16059/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Marci E Lait, MD

  • Otolaryngology Physician
  • Nags Head, NC
  • NPI 1649258617

  NC, Otolaryngology

  Medicare reassignment NPD Authorized official
• Elizabeth L Brennan, PT

  • Physical Therapist
  • Nags Head, NC
  • NPI 1649001462
  NPD

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1295255255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY STE 1C",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598996",
            "telephone_number": "252-489-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY STE 1C",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598996",
            "telephone_number": "252-489-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER EAR NOSE AND THROAT, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LAIT",
        "authorized_official_first_name": "MARCI",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-489-4682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Arthur Bald, DDS
• Shaina Barnes, FNP-C
• Beach Medical Care, LTD.
• Donald Lewis Beale, MSW, LCSW
• Bear Drugs of Nags Head Inc.
• Jessica Cecco Boone, CCC-SLP
• Elizabeth L Brennan, PT
• Priscilla NA Broussard, LAC
• Heather Brown, APRN, FNP-BC
• Rani Buglione, D.O.

• Otolaryngology Physician in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.