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BLUEWATER MEDICINE
NPI 1962593574
Internal Medicine in Niceville, FL

Active since September 27, 2006
4566 E HIGHWAY 20 STE 103, NICEVILLE, FL 32578(850) 897-1223(850) 897-1237 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 29, 2021, Aug 22, 2020 (2 updates tracked since 2020).

About Bluewater Medicine NPPES

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

BLUEWATER MEDICINE (NPI 1962593574) is a healthcare organization registered as an internal medicine in Niceville, Florida and active in the NPI registry since September 2006. The organization lists Kenneth Wayne Ponder, President, as its authorized official.

NPPES Registry Identity

NPI1962593574
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKENNETH W PONDER MD PA
Location Address4566 E HIGHWAY 20 STE 103Niceville, FL 32578-8839
Mailing Address4704 Knollwood RdNiceville, FL 32578-8760 · (850) 517-7877 · Fax (832) 336-3826
Phone(850) 897-1223
Fax(850) 897-1237
Organization SubpartNo
Authorized OfficialKenneth Wayne PonderPresident · (850) 517-7877
Enumeration DateSeptember 27, 2006
Last NPPES UpdateDecember 29, 20212 updates tracked since enumeration
NPPES CertifiedDecember 29, 2021
✔ NPI 1962593574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME0063310
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4566 E HIGHWAY 20 STE 103, Niceville, FL 32578
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Other Names 1

Doing Business AsBluewater Medicine

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

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 Kenneth W Ponder MD PA's NPI number?

The NPI number for Kenneth W Ponder MD PA is 1962593574. It was assigned to this organization in the NPPES registry on September 27, 2006. The provider is doing business as Bluewater Medicine.

Where is Kenneth W Ponder MD PA located?

Kenneth W Ponder MD PA is located at 4566 E Highway 20 Ste 103, Niceville, FL 32578. The listed phone number is (850) 897-1223.

What is Kenneth W Ponder MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Kenneth W Ponder MD PA was last updated on December 29, 2021. 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.