Organization Active NPI

Blue Ridge Integrative Wellness LLC

  • Pulmonary Disease Physician
  • Dryden, VA
National Provider Identifier
1083192595
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
BLUE RIDGE INTEGRATIVE WELLNESS LLC
Practice address
512 Dryden Loop
Dryden, VA 24243
Phone
(252) 832-1588
Fax
(276) 246-1658
NPI assigned
Aug 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Mr. Rodney Terry
Title
Project Director
Phone
(252) 452-6075

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

512 Dryden Loop
Dryden, VA 24243

Mailing address

189 Dinsmore Rd
Dryden, VA 24243-8378
Phone (276) 832-1588

Other names 1

  • The Carson Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

850 Riverview Ave
Fl 3
Pineville, KY 40977
Phone (252) 452-4080

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1083192595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 DINSMORE RD",
            "city": "DRYDEN",
            "state": "VA",
            "postal_code": "242438378",
            "telephone_number": "276-832-1588",
            "fax_number": "276-246-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 DRYDEN LOOP",
            "city": "DRYDEN",
            "state": "VA",
            "postal_code": "24243",
            "telephone_number": "252-832-1588",
            "fax_number": "276-246-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE INTEGRATIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "PROJECT DIRECTOR",
        "authorized_official_telephone_number": "252-452-6075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Carson Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dryden, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.