NPIMap

Organization Active NPI

Blue Water Internal Medicine Associates PC

  • Internal Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1720181332
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLUE WATER INTERNAL MEDICINE ASSOCIATES PC
Practice address
1987 McCulloch Blvd N
Suite 101
Lake Havasu City, AZ 86403-5682
Phone
(928) 453-6963
Fax
(928) 453-7006
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Ms. Cathy Blackwell
Title
Office Manager
Phone
(928) 453-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1987 McCulloch Blvd N
Suite 101
Lake Havasu City, AZ 86403-5682

Mailing address

PO Box 2760
Lake Havasu City, AZ 86405
Phone (928) 453-8100

Other names 1

  • Arizona Osteoporosis Centers Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1720181332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2760",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86405",
            "telephone_number": "928-453-8100",
            "fax_number": "928-453-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 MCCULLOCH BLVD N",
            "address_2": "SUITE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035682",
            "telephone_number": "928-453-6963",
            "fax_number": "928-453-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER INTERNAL MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-453-8100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Osteoporosis Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.