NPIMap

Organization Active NPI

Blue Water OB & GYN PC

  • Obstetrics & Gynecology Physician
  • Port Huron, MI
National Provider Identifier
1508954603
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BLUE WATER OB & GYN PC
Practice address
1313 Stone St
Port Huron, MI 48060-3520
Phone
(810) 984-3559
Fax
(810) 985-5196
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Dr. Eric James Hartman, MDNPI 1174557029
Title
President
Phone
(810) 984-3559

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1313 Stone St
Port Huron, MI 48060-3520

Mailing address

1313 Stone St
Port Huron, MI 48060-3520
Phone (810) 984-3559

Other identifiers 1

IdentifierTypeStateIssuer
0G46050OtherMIBCBSMI

National Provider Directory

National Provider Directory

Locations

1313 Stone St
Port Huron, MI 48060
Phone (810) 984-3181

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1508954603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520",
            "telephone_number": "810-984-3559",
            "fax_number": "810-985-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520",
            "telephone_number": "810-984-3559",
            "fax_number": "810-985-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER OB & GYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-984-3559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI",
            "identifier": "0G46050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.