Bluewater Wellness Group LLC

Primary specialty

Pediatric ChiropractorTaxonomy code 111NP0017X

Legal business name

BLUEWATER WELLNESS GROUP LLC

Practice address

4400 E Highway 20 Ste 207
Niceville, FL 32578-7700

Phone

(850) 897-1177

NPI assigned

Dec 2, 2019

Last updated

Dec 2, 2019By 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

Letitia Smith

Title

Chiropractor/ Owner

Phone

(757) 329-7145

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1538706288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4854 ORLIMAR ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 207",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-897-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEWATER WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LETITIA",
        "authorized_official_title_or_position": "CHIROPRACTOR/ OWNER",
        "authorized_official_telephone_number": "757-329-7145"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluewater Orthopedics, P.a.
• Bluewater Orthopedics, PA
• Bluewater Plastic Surgery & Cosmetic Center
• Bluewater Primary Care, Inc
• Bluewater Radiology, PLLC (Bluewater Diagnostic Imaging)
• Amy Elissa Bogan, BSW
• Charae Bond, RPH
• Alexis Alicia Bonton
• Boobology With Dr. Momo
• Amanda J Boone, LMT MA55291

• Pediatric Chiropractor in Niceville, FL
• Providers in Niceville, FL by specialty
• Pediatric Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.