Active NPI
Blue Water Anesthesia Services
- Anesthesiology Physician
- Port St Lucie, FL
National Provider Identifier
1972163533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- BLUE WATER ANESTHESIA SERVICES
- Practice address
- 6830 S US Highway 1
Port St Lucie, FL 34952-1410 - Phone
- (772) 873-6700
- NPI assigned
- Jun 17, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Barbara Allen
- Title
- Administrator
- Phone
- (772) 464-9595
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
6830 S US Highway 1
Port St Lucie, FL 34952-1410
Mailing address
6830 S US Highway 1
Port Saint Lucie, FL 34952-1410
Phone (772) 873-6700
National Provider Directory
National Provider DirectoryLocations
6830 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 873-6700
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Otolaryngology Physician
- Port St Lucie, FL
- NPI 1396703856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667952000000",
"number": "1972163533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6830 S US HIGHWAY 1",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349521410",
"telephone_number": "772-873-6700",
"fax_number": "772-465-5499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6830 S US HIGHWAY 1",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349521410",
"telephone_number": "772-873-6700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE WATER ANESTHESIA SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-17",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A",
"authorized_official_last_name": "ALLEN",
"authorized_official_first_name": "BARBARA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "772-464-9595"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.