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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

OPEN WATER MEDICAL, PA
NPI 1003730169
General Practice in Sea Level, NC

Active since August 10, 2026CLIA Certified · 2 labs
458 HWY 70 EAST, SEA LEVEL, NC 28577(252) 728-5737 Get Directions Write a Review

NPPES record added: August 10, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Open Water Medical, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OPEN WATER MEDICAL, PA (NPI 1003730169) is a healthcare organization registered as a general practice in Sea Level, North Carolina and active in the NPI registry since August 2026. The organization holds 2 active CLIA laboratory certificates and lists Samuel Willis, Coo, as its authorized official.

NPPES Registry Identity

NPI1003730169
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameOPEN WATER MEDICAL, PA
Location Address458 HWY 70 EASTSea Level, NC 28577
Mailing Address1620c Live Oak StBeaufort, NC 28516-1583 · (252) 728-5737 · Fax (252) 723-5739
Phone(252) 728-5737
Organization SubpartYes
Authorized OfficialSamuel WillisCoo · (252) 723-7234
Enumeration DateAugust 10, 2026
NPPES CertifiedJuly 30, 2026
✔ NPI 1003730169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
458 HWY 70 EAST, Sea Level, NC 28577
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D0715294

Open Water Medical, PA · Beaufort, NC
Active · expires May 22, 2028
CLIA Number34D0715294
Laboratory TypePhysician Office
Certificate Effective DateMay 23, 2026
Certificate Expiration DateMay 22, 2028
Laboratory DirectorKerry A. Willis
Laboratory Phone(252) 728-5737
Laboratory LocationOpen Water Medical, PA1620 C Live Oak Street, Beaufort, NC 28516
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 34D2254449

Open Water Medical, PA · Newport, NC
Active · expires Mar 2, 2028
CLIA Number34D2254449
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateMarch 2, 2028
Laboratory DirectorKerry A. Willis
Laboratory Phone(252) 728-5737
Laboratory LocationOpen Water Medical, PA263 Howard Blvd, Newport, NC 28570
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOMER CURTISS MERRICK M.D.
Internal Medicine
458 HWY 70 EAST
SEALEVEL, NC 28577
Carteret County (252) 225-1134

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Open Water Medical, PA's NPI number?

The NPI number for Open Water Medical, PA is 1003730169. It was assigned to this organization in the NPPES registry on August 10, 2026.

Where is Open Water Medical, PA located?

Open Water Medical, PA is located at 458 Hwy 70 East, Sea Level, NC 28577. The listed phone number is (252) 728-5737.

What is Open Water Medical, PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Open Water Medical, PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Open Water Medical, PA was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.