Active NPI
Blue Water Physiatry L L C
- Physical Medicine & Rehabilitation Physician
- Clinton, MD
National Provider Identifier
1770764490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- D0039416
- Legal business name
- BLUE WATER PHYSIATRY L L C
- Practice address
- 7501 Surratts Road
#202
Clinton, MD 20735-2256 - Phone
- (301) 877-6110
- Fax
- (301) 877-2695
- NPI assigned
- Nov 21, 2007
- Last updated
- Feb 14, 2012
- Organization subpart
- Yes
- Parent organization
- BLUE WATER PHYSIATRY L L C
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Arthur Peter Barletta, MD
- Title
- President
- Phone
- (301) 877-6110
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | D0039416 | MD | Primary |
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | D0039416 | MD |
Addresses
Primary practice location
7501 Surratts Road
#202
Clinton, MD 20735-2256
Mailing address
6368 Coventry Way
#365
Clinton, MD 20735-2256
Phone (301) 877-6110
National Provider Directory
National Provider Directory- Part of
- Blue Water Psychiatry LLC
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Oxon Hill, MD
- NPI 1669461166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195603200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329177600000",
"number": "1770764490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6368 COVENTRY WAY",
"address_2": "#365",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352256",
"telephone_number": "301-877-6110",
"fax_number": "301-877-2695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7501 SURRATTS ROAD",
"address_2": "#202",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352256",
"telephone_number": "301-877-6110",
"fax_number": "301-877-2695"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE WATER PHYSIATRY L L C",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BLUE WATER PHYSIATRY L L C",
"enumeration_date": "2007-11-21",
"last_updated": "2012-02-14",
"status": "A",
"authorized_official_last_name": "BARLETTA",
"authorized_official_first_name": "ARTHUR",
"authorized_official_middle_name": "PETER",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "301-877-6110",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "MD",
"license": "D0039416",
"primary": true
},
{
"code": "2081P2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "MD",
"license": "D0039416",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.