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BLUE WATER CHILDREN'S HEALTH CARE
NPI 1962003566
Pediatrics in Fort Gratiot, MI

Active since November 02, 2020CLIA 23D0987458 · Waiver
3030 COMMERCE DR, FORT GRATIOT, MI 48059(810) 385-9559(810) 385-9515 Get Directions Write a Review

NPPES record last updated: November 2, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Blue Water Children's Health Care NPPES

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

BLUE WATER CHILDREN'S HEALTH CARE (NPI 1962003566) is a healthcare organization registered as a pediatrics in Fort Gratiot, Michigan and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through June 4, 2027 and lists Dev Nandamudi, Md, as its authorized official.

NPPES Registry Identity

NPI1962003566
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBLUE WATER CHILDREN'S HEALTH CARE
Location Address3030 COMMERCE DRFort Gratiot, MI 48059-3819
Mailing Address3030 Commerce DrFort Gratiot, MI 48059-3819 · (810) 385-9559 · Fax (810) 385-9515
Phone(810) 385-9559
Fax(810) 385-9515
Organization SubpartNo
Authorized OfficialDev NandamudiMd · (810) 385-9559
Enumeration DateNovember 2, 2020
NPPES CertifiedNovember 2, 2020
✔ NPI 1962003566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3030 COMMERCE DR, Fort Gratiot, MI 48059
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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 23D0987458

Blue Water Children's Health Care, PLLC · Fort Gratiot, MI
Active · expires Jun 4, 2027
CLIA Number23D0987458
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorDev Nandamudi MD
Laboratory Phone(810) 432-8448
Laboratory LocationBlue Water Children's Health Care, PLLC3030 Commerce Drive, Fort Gratiot, MI 48059
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MEGAN NICOLE GEISER PNP
Nurse Practitioner (Pediatrics)
3030 COMMERCE DR
FORT GRATIOT, MI 48059
St. Clair County (810) 385-9559
DEV S NANDAMUDI M.D.
Pediatrics
3030 COMMERCE DR
FORT GRATIOT, MI 48059
St. Clair County (810) 385-9559
KELSEY KATHERINE BAKER CPNP
Nurse Practitioner (Pediatrics)
3030 COMMERCE DR
FORT GRATIOT, MI 48059
St. Clair County (810) 385-5995

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 Blue Water Children's Health Care's NPI number?

The NPI number for Blue Water Children's Health Care is 1962003566. It was assigned to this organization in the NPPES registry on November 2, 2020.

Where is Blue Water Children's Health Care located?

Blue Water Children's Health Care is located at 3030 Commerce Dr, Fort Gratiot, MI 48059. The listed phone number is (810) 385-9559.

What is Blue Water Children's Health Care's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Blue Water Children's Health Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0987458) is associated with this NPI, valid through June 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Blue Water Children's Health Care accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Blue Water Children's Health Care as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blue Water Children's Health Care was last updated on November 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.