Blue Water Asc LLC · Ambulatory Surgical Clinic/Center

920 River Centre Dr, Port Huron, MI 48060-4463

Overview

Blue Water Asc LLC is a Ambulatory Surgical Clinic/Center (organization) practicing in Port Huron, Michigan. The National Provider Identifier (NPI) is #1720023690, which was assigned on June 17, 2006, and the registration record was last updated on September 23, 2025. The practitioner's main practice location is at 920 River Centre Dr, Port Huron, MI 48060-4463; the contact telephone number is 8109845200, and the fax number is 8109855050. The primary taxonomy of Blue Water Asc LLC is Ambulatory Surgical Clinic/Center (261QA1903X), with specialization in Ambulatory Surgical. The authorized official for Blue Water Asc LLC is Mr. Jeffrey Snodgrass (President). Blue Water Asc LLC is licensed to practice in the state of Michigan (#74-6817).

Provider Information

NPI 1720023690
Entity Type Organization
Organization Name BLUE WATER ASC LLC
Provider Name BLUE WATER ASC LLC
Practice Address 920 River Centre Dr
Port Huron
MI 48060-4463
Practice Telephone 8109845200
Practice Fax Number 8109855050
Mailing Address 1a Burton Hills Blvd Ste 300
Nashville
TN 37215-6153
Mailing Telephone 6152634011
Mailing Fax Number 6152341720
Certification Date 2025-09-23
Enumeration Date 2006-06-17
Last Update Date 2025-09-23
Is Organization Subpart N

Authorized Official Information

Official Name MR. JEFFREY SNODGRASS
Official Title PRESIDENT
Telephone 6156651283

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y261QA1903XClinic/CenterAmbulatory Surgical74-6817MI

Other Provider Names

Other Organization NameType
Blue Water Surgery Center, LLCDoing Business As Name

Taxonomy Information

Primary Taxonomy

Code 261QA1903X
Taxonomy Ambulatory Surgical Clinic/Center
Classification Clinic/Center
Specialization Ambulatory Surgical
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

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Location Information

Street Address 920 RIVER CENTRE DR
City PORT HURON
State MI
Zip Code 48060-4463
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Emily Tan 940 River Centre Dr, Port Huron, MI 48060-4463Orthopaedic Hand Surgery Physician2014-04-23
Hannah Briann Kohler 940 River Centre Dr, Port Huron, MI 48060-4463Nurse Practitioner2022-08-19
Kyrollos Boules 940 River Centre Dr, Port Huron, MI 48060-4463Physical Therapist2022-01-20

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Irb Medical Equipment LLC 2001 Holland Ave, Suite A, Port Huron, MI 48060-1519Durable Medical Equipment & Medical Supplies2014-10-03
Karen Margaret Wood 2186 Water St, Port Huron, MI 48060-2543Clinical Social Worker2025-01-23
Wynneth Huang 1231 Pine Grove Ave Ste 1a, Port Huron, MI 48060-3500Physician Assistant2021-09-08
Noah Gunderson 3112 Wright St, Port Huron, MI 48060-2263Behavior Technician2026-01-05
Vinculum Care Foundation 1530 Pine Grove Ave, Port Huron, MI 48060-3370Case Management Registered Nurse2026-03-03
Rachel Distelrath · Rachel Mcgregor 1210 10th Ave, Port Huron, MI 48060-3406Family Nurse Practitioner2024-11-25
James Saad 1014 Holland Ave, Port Huron, MI 48060-1513Behavior Technician2023-09-21
Kaitlyn Marie Mahaffy · Kaitlyn Marie Amey 1210 10th Ave, Port Huron, MI 48060-3406Family Nurse Practitioner2024-01-22
Nathanael William Russell 2837 Walnut St, Port Huron, MI 48060-2162Clinical Social Worker2020-04-06
Enlightened Mind LLC 2837 Walnut St, Port Huron, MI 48060-2162Clinical Social Worker2023-02-28
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.