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

Open Water Medical, PA

Organization Family Medicine Physician · NPI 1720550940

Open Water Medical, PA is a Family Medicine Physician in Goldsboro, North Carolina. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
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

1209 E Ash St
Goldsboro, NC 27530-5103
Phone: (919) 734-9455
Fax: (919) 734-4769
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1720550940
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tisha Smith — Practice Manager · (252) 728-5737
NPI enumeratedDecember 28, 2018
Last updated in NPPESFebruary 24, 2022
Certification dateFebruary 24, 2022
Mailing address1620c Live Oak St, Beaufort, NC 28516-1583

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