Blue Ridge Neuropsychology PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001474 Issued in VA

Legal business name

BLUE RIDGE NEUROPSYCHOLOGY PC

Practice address

40 Lambert St
Ste 222
Staunton, VA 24401-2446

Phone

(540) 886-3956

Fax

(540) 886-3975

NPI assigned

Mar 17, 2016

Last updated

Nov 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas V RyanNPI 1750554036

Title

Clinical Psychologist

Phone

(540) 886-3956

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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.

• Thomas Vincent Ryan, PHD ABPP CN

  • Clinical Psychologist
  • Staunton, VA
  • NPI 1750554036
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1104287168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LAMBERT ST",
            "address_2": "STE 222",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012446",
            "telephone_number": "540-886-3956",
            "fax_number": "540-886-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LAMBERT ST",
            "address_2": "STE 222",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012446",
            "telephone_number": "540-886-3956",
            "fax_number": "540-886-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE NEUROPSYCHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "540-886-3956"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1750554036",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Birch Gardens
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• Blue Ridge Radiologists Inc.
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• Jeffrey Bonacci, M.D.
• Alexis Borja

• Clinical Psychologist in Staunton, VA
• Providers in Staunton, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.