NPIMap

Organization Active NPI

Blue Ridge Healthcare Medical Group, Inc.

Doing business as Valdese Medical Associates

  • Family Medicine Physician
  • Connelly Springs, NC
National Provider Identifier
1043618523
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Doing business as
Valdese Medical Associates
Practice address
730 Malcolm Blvd Ste 150
Connelly Springs, NC 28612-8079
Phone
(828) 874-4600
Fax
(828) 874-8900
NPI assigned
Dec 15, 2014
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Patricia Moll
Title
SVP-Cfo
Phone
(828) 580-5003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

730 Malcolm Blvd Ste 150
Connelly Springs, NC 28612-8079

Mailing address

730 Malcolm Blvd Ste 150
Connelly Springs, NC 28612-8079
Phone (828) 874-4600

Other identifiers 1

IdentifierTypeStateIssuer
1043618523OtherNCMEDICAID GROUP ID

Other names 1

  • Valdese Medical Associates Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000601 NC Part B Supplier - Clinic/Group Practice 9436159712 Receives reassigned benefits from 346 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Morganton, NC; Marion, NC; Morgantown, NC; Nebo, NC; Valdese, NC; Winterville, NC; Connelly Springs, NC; Granite Falls, NC…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1044795Valdese Medical Associates730 Malcolm Boulevard, Suite 150, Connelly Springs, NC 28612Provider-performed microscopyAug 28, 2027

National Provider Directory

National Provider Directory

Locations

695 W Fleming Dr
Morganton, NC 28655
Phone (828) 580-3278

Practitioners & affiliated clinicians

Practitioners 12

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": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1043618523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 MALCOLM BLVD STE 150",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128079",
            "telephone_number": "828-874-4600",
            "fax_number": "828-874-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MALCOLM BLVD STE 150",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128079",
            "telephone_number": "828-874-4600",
            "fax_number": "828-874-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "MOLL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "SVP-CFO",
        "authorized_official_telephone_number": "828-580-5003"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP ID",
            "identifier": "1043618523",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Valdese Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connelly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.