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OPEN WATER MEDICAL, PA
NPI 1669852372
Family Medicine in Morehead City, NC

Active since June 08, 2015CLIA 34D1088471 · Waiver
3106 ARENDELL STREET, MOREHEAD CITY, NC 28557(252) 808-2500(252) 808-2501 Get Directions Write a Review

NPPES record last updated: February 24, 2022. Verified against the NPPES registry weekly; last sync: August 02, 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 1669852372) is a healthcare organization registered as a family medicine in Morehead City, North Carolina and active in the NPI registry since June 2015. The organization holds a CLIA Waiver certificate valid through August 25, 2026 and lists Tisha Rae Smith, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1669852372
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOPEN WATER MEDICAL, PA
Location Address3106 ARENDELL STREETMorehead City, NC 28557-3202
Mailing Address1620 C Live Oak StreetBeaufort, NC 28516-1583 · (252) 728-5737 · Fax (252) 728-5739
Phone(252) 808-2500
Fax(252) 808-2501
Organization SubpartNo
Authorized OfficialTisha Rae SmithPractice Manager · (252) 728-5737
Enumeration DateJune 8, 2015
Last NPPES UpdateFebruary 24, 2022
NPPES CertifiedFebruary 24, 2022
✔ NPI 1669852372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 30580
Definition
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.
3106 ARENDELL STREET, Morehead City, NC 28557
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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

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 of Waiver 34D1088471

Open Water Medical, PA · Morehead City, NC
Active · expires Aug 25, 2026
CLIA Number34D1088471
Laboratory TypePhysician Office
Certificate Effective DateAugust 26, 2024
Certificate Expiration DateAugust 25, 2026
Laboratory DirectorKerry A. Willis
Laboratory Phone(252) 808-2500
Laboratory LocationOpen Water Medical, PA3106 Arendell Street, Morehead City, NC 28557
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

MR. WILLIAM CLEATON RAWLS JR. MD
Obstetrics & Gynecology (Gynecology)
3106 ARENDELL STREET
MOREHEAD CITY, NC 28557
Carteret County (252) 808-2500
SOUNDSIDE HEALTHCARE FOR WOMEN PC
Obstetrics & Gynecology (Gynecology)
3106 ARENDELL STREET
MOREHEAD CITY, NC 28557
Carteret County (252) 808-2500

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 1669852372. It was assigned to this organization in the NPPES registry on June 8, 2015.

Where is Open Water Medical, PA located?

Open Water Medical, PA is located at 3106 Arendell Street, Morehead City, NC 28557. The listed phone number is (252) 808-2500.

What is Open Water Medical, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Open Water Medical, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1088471) is associated with this NPI, valid through August 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Open Water Medical, PA was last updated on February 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.