NPIMap

Organization Active NPI

Blue Ridge Orthopaedic Assoc PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Seneca, SC
National Provider Identifier
1033141502
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
BLUE RIDGE ORTHOPAEDIC ASSOC PA
Practice address
10630 Clemson Blvd
Suite 100
Seneca, SC 29678-4546
Phone
(864) 482-6000
NPI assigned
Jul 7, 2006
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jo Stokes
Title
Administrator
Phone
(864) 482-6165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X SC Primary

Addresses

Primary practice location

10630 Clemson Blvd
Suite 100
Seneca, SC 29678-4546

Mailing address

10630 Clemson Blvd
Suite 100
Seneca, SC 29678-4545
Phone (864) 482-6000

Other identifiers 1

IdentifierTypeStateIssuer
PA4584MedicaidSC

Other names 1

  • Blue Ridge Orthopaedics Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1033141502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD",
            "address_2": "SUITE 100",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784545",
            "telephone_number": "864-482-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD",
            "address_2": "SUITE 100",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784546",
            "telephone_number": "864-482-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE ORTHOPAEDIC ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "864-482-6165",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA4584",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Orthopaedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.