Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Open Water Medical, PA

Organization Family Medicine Physician · NPI 1497490957

Open Water Medical, PA is a Family Medicine Physician in Jacksonville, North Carolina. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11 Ofc Park DR
Jacksonville, NC 28546-7326
Phone: (910) 353-9906
Fax: (910) 353-4853
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1497490957
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tisha Smith — Practice Manager · (252) 728-5737
NPI enumeratedApril 29, 2022
Last updated in NPPESApril 29, 2022
Certification dateApril 29, 2022
Mailing address1620c Live Oak St, Beaufort, NC 28516-1583

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