Blue Ridge Medical Center

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP009050 Issued in PA

Legal business name

BLUE RIDGE MEDICAL CENTER

Practice address

433 Church St
New Milford, PA 18834-6603

Phone

(570) 465-4500

Fax

(570) 465-4501

NPI assigned

Oct 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Nichole Rosa, CRNP

Title

Owner

Phone

(607) 237-1209

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1164775342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 CHURCH ST",
            "address_2": "P.O. BOX 602",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188346603",
            "telephone_number": "570-465-4500",
            "fax_number": "570-465-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 CHURCH ST",
            "city": "NEW MILFORD",
            "state": "PA",
            "postal_code": "188346603",
            "telephone_number": "570-465-4500",
            "fax_number": "570-465-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "ROSA",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-237-1209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "BM2828929",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William G Albert III, DC
• Alexis Axtell, PA-C
• Barnes-Kasson County Hospital
• Barnes-Kasson County Hospital
• Susan Marie Begasse, CRNP
• Blue Ridge School District
• Pamela Brant, MA
• Edmund W Burdick, OD
• Elizabeth M Ciavola, DC
• Columbia Hose Company No 1

• Family Nurse Practitioner in New Milford, PA
• Providers in New Milford, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.