Organization Active NPI

Blue Sky Iop

  • Substance Abuse Rehabilitation Facility
  • Durham, NC
National Provider Identifier
1063200772
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
BLUE SKY IOP
Practice address
1800 Martin Luther King Pkwy Ste 204
Durham, NC 27707-3500
Phone
(984) 209-4645
Fax
(323) 213-7885
NPI assigned
Apr 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Nicholas Moore
Title
Managing Member
Phone
(323) 394-9671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1800 Martin Luther King Pkwy Ste 204
Durham, NC 27707-3500

Mailing address

1800 Martin Luther King Pkwy Ste 204
Durham, NC 27707-3500
Phone (984) 209-4645

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
34D2328477Blue Sky Iop, LLC1800 Martin Luther King Jr Pkwy, Ste 204, Durham, NC 27707Certificate of waiverAug 10, 2027

National Provider Directory

National Provider Directory

Locations

1800 Martin Luther King Pkwy
Ste 204
Durham, NC 27707
Phone (984) 209-4645

NPI Registry JSON

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1063200772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MARTIN LUTHER KING PKWY STE 204",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073500",
            "telephone_number": "984-209-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MARTIN LUTHER KING PKWY STE 204",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073500",
            "telephone_number": "984-209-4645",
            "fax_number": "323-213-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY IOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "323-394-9671"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.