Blue Ridge Healthcare Medical Group, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.

Doing business as

Jayendrakumar I Patel, MD

Practice address

722 Malcolm Blvd.
Connelly Springs, NC 28612

Phone

(828) 580-7655

Fax

(828) 874-2278

NPI assigned

Sep 29, 2008

Last updated

Feb 14, 2023By 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

Patricia Moll

Title

Cfo

Phone

(828) 580-5003

Specialties & licenses 1

Addresses

Other names 1

• Jayendrakumar I Patel, MD Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 2

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.

• Emily Laine Farris, PT

  • Physical Therapist
  • Sylva, NC
  • NPI 1043985724
  NPD
• Quincy Justin Greene, M.D.

  • Surgery Physician
  • Connelly Springs, NC
  • NPI 1457492175
  NPD

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1154571081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 MALCOLM BLVD.",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "28612",
            "telephone_number": "828-580-7655",
            "fax_number": "828-874-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 MALCOLM BLVD.",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "28612",
            "telephone_number": "828-580-7655",
            "fax_number": "828-874-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "MOLL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "828-580-5003"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jayendrakumar I Patel, MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jayendrakumar I Patel, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Brian Bauer, M.D.
• Kaitlyn Brooke Berry
• John Clements Betancourt, MD
• Blue Ridge Healthcare Medical Group, Inc (The Cancer Center at Blue Ridge Valdese)
• Blue Ridge Healthcare Medical Group, Inc. (Valdese Medical Associates)
• Blue Ridge Healthcare Medical Group, Inc. (Women's Health Group-Valdese)
• Blue Ridge Healthcare Medical Group, Inc. (Blue Ridge HealthCare Urology)
• Blue Ridge Healthcare Medical Group, Inc. (Alan F. Jacks, MD, PA)
• Blue Ridge Medical Group, Inc (Gastroenterology Specialists, PA)
• Randall Josiah Bosley

• Surgery Physician in Connelly Springs, NC
• Providers in Connelly Springs, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.