OPEN WATER MEDICAL, PA (NPI# 1760921613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760921613 |
Entity Type | Organization |
Organization Name | OPEN WATER MEDICAL, PA |
Practice Address |
109 South Vance St Sanford NC 27330 |
Mailing Address |
1620 C Live Oak St Beaufort NC 28516 |
Practice Telephone | 9197764040 |
Practice Fax Number | 9197764043 |
Mailing Telephone | 2527285737 |
Mailing Fax Number | 2527285739 |
Enumeration Date | 2017-02-13 |
Last Update Date | 2017-02-13 |
Authorized Official Name | KERRY A WILLIS (PRESIDENT) |
Authorized Official Telephone | 2527237233 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 30580 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 890159M | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
1437531100 | Open Water Medical, Pa | Family Medicine | 1303 Water Plant Rd, Zebulon, NC 27597-8615 | 2015-06-18 |
1750482493 | Open Water Medical, Pa | Clinic/Center | 1620 Live Oak St Ste C, Beaufort, NC 28516-1582 | 2006-09-26 |
1720550940 | Open Water Medical, Pa | Clinic/Center | 1209 E Ash St, Goldsboro, NC 27530-5103 | 2018-12-28 |
1669852372 | Open Water Medical, Pa | Family Medicine | 3106 Arendell Street, Morehead City, NC 28557-3202 | 2015-06-08 |
Street Address |
109 SOUTH VANCE ST |
City | SANFORD |
State | NC |
Zip Code | 27330 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043836232 | Felicia Alston | Chore Provider | 160a Chatham St, Sanford, NC 27330 | 2020-06-23 |
1730727470 | Kathy M Taylor | Homemaker | 1665 Lower Moncure Rd, Sanford, NC 27330 | 2019-12-12 |
1982185377 | Fhpg, LLC | Internal Medicine | 2925 Beechtree Dr, Suite 142, Sanford, NC 27330 | 2018-08-24 |
1154849719 | Schuyler Karl Behnke | Family Medicine | 125 Chatham Street, Sanford, NC 27330 | 2017-09-05 |
1205375953 | Dlp Central Carolina Medical Group LLC | Surgery | 117 Dennis Dr, Sanford, NC 27330 | 2017-02-14 |
1972050458 | Brent Layne | Physician Assistant | 724 South Horner Blvd, Sanford, NC 27330 | 2016-09-01 |
1174977185 | Jennifer Lynn Beard | Physician Assistant | 2412 Wilkins Drive, Sanford, NC 27330 | 2016-04-15 |
1003277252 | North Carolina Wellness | Community/Behavioral Health | 321a Court Square, Sanford, NC 27330 | 2016-03-16 |
1518343573 | The Family Doc Back To Basics Medical Practice, Pllc | General Practice | 1503 Elm Street, Suite C, Sanford, NC 27330 | 2015-07-31 |
1013305390 | Senitra Pryor | Counselor | 811 North Horner Blvd, Sanford, NC 27330 | 2015-01-08 |
Find all providers in zip 27330 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225637333 | Mcpc-8, LLC | Family Medicine | 3110 S Horner Blvd Ste 4&5, Sanford, NC 27332-8212 | 2020-10-20 |
1619463429 | Fhpg, LLC | Family Medicine | 2919 Beechtree Dr, Sanford, NC 27330-6934 | 2018-07-04 |
1154849719 | Schuyler Karl Behnke | Family Medicine | 125 Chatham Street, Sanford, NC 27330 | 2017-09-05 |
1912318247 | Malathy T Sundaram M.d, LLC | Family Medicine | 312 Cottage St Ste A, Sanford, ME 04073-1817 | 2014-05-08 |
1487998738 | Carehere LLC | Family Medicine | 1403 Medical Plaza Dr Ste 205, Sanford, FL 32771-1047 | 2012-11-26 |
1508120734 | Jennifer Roehrs | Family Medicine | 2919 Beechtree Dr Ste 1120, Sanford, NC 27330-6934 | 2012-07-03 |
1871899021 | Urgent Cares of America North Carolina Inc | Family Medicine | 724 South Horner Blvd., Sanford, NC 27330 | 2011-02-07 |
1447567698 | Shri Hari Clinic, LLC | Family Medicine | 2200 S French Ave, Sanford, FL 32771-4253 | 2010-09-09 |
1336303346 | Thang Pham | Family Medicine | 211 Bush Blvd, Sanford, FL 32773-6188 | 2008-07-18 |
1770780611 | Robert Seitz Cline | Family Medicine | 801 Stuart Dr, Sanford, NC 27330-7625 | 2007-07-02 |
Find all providers in SANFORD |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.