BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. (NPI# 1083854251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083854251 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. |
| Other Organization Name | BLUE RIDGE ENT & ALLERGY |
| Practice Address |
352-b East Parker Road Morganton NC 28655 |
| Practice Telephone | 8284336410 |
| Practice Fax Number | 8284384779 |
| Mailing Telephone | 8284336410 |
| Mailing Fax Number | 8284384779 |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2010-04-27 |
| Authorized Official Name | ROBERT FRITTS (SVP-CFO) |
| Authorized Official Telephone | 8285805545 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
200301349 | NC | Allopathic & Osteopathic Physicians |
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
200301349 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC LICENSE | 200301349 | 01 |
| Other Name | Type Code |
|---|---|
| Blue Ridge ENT & Allergy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396017752 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 2293 Sugar Hill Rd, Suite B, Marion, NC 28752-7787 | 2012-02-01 |
| 1407188600 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 117-b Foothills Dr, Morganton, NC 28655 | 2010-02-12 |
| 1548497209 | Blue Ridge Healthcare Medical Group, Inc. | Obstetrics & Gynecology | 20 S Medical Ct, Marion, NC 28752-4972 | 2009-06-19 |
| 1275725996 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 111 Foothills Dr Ste B, Morganton, NC 28655-5123 | 2007-08-16 |
| 1639244478 | Blue Ridge Healthcare Medical Group, Inc. | Radiology | 2201 S. Sterling Street, Morganton, NC 28655 | 2006-11-21 |
| 1972683126 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 2209 S. Sterling Street, Suite 300, Morganton, NC 28655 | 2006-10-16 |
| 1780772715 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 730 Malcolm Blvd., Suite 230, Rutherford College, NC 28671 | 2006-10-11 |
| 1891884748 | Blue Ridge Healthcare Medical Group, Inc. | Psychiatry & Neurology | 2201 S. Sterling St., Morganton, NC 28655 | 2006-10-11 |
| 1235227257 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 1901 Connelly Springs Road, Lenoir, NC 28645 | 2006-10-11 |
| 1942301957 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 2659 Us Hwy 70 E, Valdese, NC 28690-0008 | 2006-09-25 |
| Street Address |
352-B EAST PARKER ROAD |
| City | MORGANTON |
| State | NC |
| Zip Code | 28655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811128 | Foothills Family Dermatology | Dermatology | 118 North Sterling St, Morganton, NC 28655 | 2020-11-04 |
| 1225678071 | Melissa Marie Sisco | Psychologist | Broughton State Hospital, 1000 S. Sterling Street, Morganton, NC 28655 | 2020-01-09 |
| 1043864598 | Stout Scripts, Inc. | Pharmacy | 200 West Fleming Dr, Morganton, NC 28655 | 2019-08-01 |
| 1538626015 | Morganton Opco Holdings, LLC | Assisted Living Facility | 330 Juniper St, Morganton, NC 28655 | 2019-02-21 |
| 1982174843 | Katie Breeze Heald Dds PC | Dentist | 679 W. Fleming Dr., Morganton, NC 28655 | 2018-12-04 |
| 1104317353 | Dr Liner Ward & Shobe Dds Pa | Dentist | 503 S. Green Street, Morganton, NC 28655 | 2018-05-23 |
| 1578069779 | Catawba Valley Medical Servies | Speech-Language Pathologist | 409b S Sterling St, Morganton, NC 28655 | 2018-04-05 |
| 1336685601 | Clear Perspective, LLC | Counselor | 140 Beach Street, Morganton, NC 28655 | 2017-01-11 |
| 1245604800 | Burke Integrated Health | Family Medicine | 350 East Parker Road, Morganton, NC 28655 | 2015-11-19 |
| 1881079929 | Legacy Healthcare Services, Inc | General Acute Care Hospital | 4263 Bill Dale Rd, Morganton, NC 28655 | 2015-07-29 |
| Find all providers in zip 28655 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891958229 | Gregory Allen Garth | Otolaryngology | 895 State Farm Road, Suite 301, Boone, NC 28607-4917 | 2008-07-07 |
| 1902822976 | John Brian Thomas Wood | Otolaryngology | 1141 North Road Street, Ste K, Elizabeth City, NC 27909 | 2006-07-14 |
| 1629048004 | Jared Spector | Otolaryngology | 601 Keisler Dr, Suite 200, Cary, NC 27518-6566 | 2006-01-26 |
| 1407836406 | Charles B West Jr. | Otolaryngology | 124 N Park St, Asheboro, NC 27203-5440 | 2006-01-18 |
| 1225037195 | Edward J Silvoy | Otolaryngology | 1010 X Ray Dr, Suite A, Gastonia, NC 28054-7488 | 2005-07-21 |
| 1053976415 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-01 |
| 1730639394 | Granville Health Inc. | Otolaryngology | 102 Professional Park, Suite C, Oxford, NC 27565-2501 | 2016-10-07 |
| 1043620347 | J Madison Clark Md Pllc | Otolaryngology | 1248 Huffman Mill Rd, Suite 201, Burlington, NC 27215-8700 | 2014-05-07 |
| 1619126992 | Randolph Specialty Group Practice | Otolaryngology | 124 N Park St, Asheboro, NC 27203-5440 | 2008-09-11 |
| 1700084951 | High Country Ear Nose and Throat Pllc | Otolaryngology | 895 State Farm Rd, Ste 303, Boone, NC 28607 | 2007-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.