Blue Water Children's Health Care

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BLUE WATER CHILDREN'S HEALTH CARE

Practice address

3030 Commerce Dr
Fort Gratiot, MI 48059-3819

Phone

(810) 385-9559

Fax

(810) 385-9515

NPI assigned

Nov 2, 2020

Last updated

Nov 2, 2020By 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

Dev Nandamudi, MDNPI 1205802436

Title

MD

Phone

(810) 385-9559

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22735/brand/1/csg/1/fhir/r4

Practitioners 10

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.

• Dev S Nandamudi, M.D.

  • Pediatrics Physician
  • Fort Gratiot, MI
  • NPI 1205802436
  NPD Authorized official
• Kelsey Katherine Baker, CPNP

  • Pediatric Nurse Practitioner
  • Fort Gratiot, MI
  • NPI 1245999432
  NPD
• Megan Nicole Geiser, PNP

  • Pediatric Nurse Practitioner
  • Fort Gratiot, MI
  • NPI 1194395947
  NPD
• Jessica Jo Grace, M.D.

  • Pediatrics Physician
  • East China, MI
  • NPI 1952490765
  NPD (past)
• Amit A Nandi, MD

  • Pediatrics Physician
  • Brockway, MI
  • NPI 1134196850
  NPD (past)
• Hemalata A Nandi, M.D.

  • Pediatrics Physician
  • Marysville, MI
  • NPI 1659347888
  NPD (past)
• Megan Dawn Parslow, NP-C

  • Primary Care Nurse Practitioner
  • Washington, MI
  • NPI 1144792458
  NPD (past)
• Rikki Pautz, PA-C

  • Physician Assistant
  • Troy, MI
  • NPI 1730551722
  NPD (past)
• Kellie Nichole Quigley, CPNP-PC

  • Pediatric Nurse Practitioner
  • Waterford, MI
  • NPI 1740054501
  NPD (past)
• Renee Ruiz, CPNP

  • Pediatric Nurse Practitioner
  • Brockway, MI
  • NPI 1760810782
  NPD (past)

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1962003566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 COMMERCE DR",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593819",
            "telephone_number": "810-385-9559",
            "fax_number": "810-385-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COMMERCE DR",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593819",
            "telephone_number": "810-385-9559",
            "fax_number": "810-385-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER CHILDREN'S HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "NANDAMUDI",
        "authorized_official_first_name": "DEV",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "810-385-9559",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gaurav Bhalla, M.D.
• Anthony J. Bianchi, DPM
• Birchwood Chiropractic Center, PLLC
• Stacy Biscorner
• Shari Blackburn
• Blue Water Family Dentistry PC
• Blue Water Mental Health Clinic (Blue Water Counseling)
• Blue Water Mental Health Clinic
• Blue Water Nursing Center (Evangelical Home - Port Huron)
• Blue Water Primary Care

• Pediatrics Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.