Blue Water Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BLUE WATER MEDICAL, INC.

Practice address

922 Gainesville Hwy
Suite 112
Buford, GA 30518-1642

Phone

(770) 355-5398

Fax

(888) 974-6246

NPI assigned

Mar 26, 2014

Last updated

Nov 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Robert Guffin

Title

President

Phone

(770) 355-5398

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1437576568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 GAINESLVILLE HWY",
            "address_2": "SUITE 112",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30518",
            "telephone_number": "770-355-5398",
            "fax_number": "888-974-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 GAINESVILLE HWY",
            "address_2": "SUITE 112",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181642",
            "telephone_number": "770-355-5398",
            "fax_number": "888-974-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "GUFFIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-355-5398",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hauser Bisig, DMD
• Maureen Sullivan Bixler, LCSW
• Jon Lee Blackard
• Abbey Blanchette
• Greta Blankenship, OTR/L
• Valeria F Boazman, MD
• Denisa Ramona Boitos
• Michelle Bolden
• William Kyle Boone, O.D.
• Alonzo Meisenzahl Borja, D.C.

• Durable Medical Equipment & Medical Supplies in Buford, GA
• Providers in Buford, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.