Blue Ridge Physicians for Women, Inc
Organization Active NPI Obstetrics & Gynecology Physician · Galax, VA
NPI 1194082149 · NPPES record last updated Feb 19, 2013
Key facts
- NPI
- 1194082149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- BLUE RIDGE PHYSICIANS FOR WOMEN, INC
- Practice address
- 227 Hospital Dr
Galax, VA 24333-2228 - Phone
- (276) 236-2909
- Fax
- (276) 236-8845
- NPI assigned
- Apr 16, 2012
- Organization subpart
- No
Authorized official
- Name
- Carlos J Blattner
- Title
- Consultant
- Phone
- (276) 236-2909
Other NPIs on the same Medicare enrollment 2
Practitioners 4
-
Joy K Creed, FNP-C
-
Katrina Bolt Parks, MSN, NP-C
-
Ashley Allen Houk, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0232437 | Blue Ridge Physicians for Women, Inc | Provider-performed microscopy | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614000157 | VA | Part B Supplier - Clinic/Group Practice | 4688658289 |
Receives reassigned benefits from 1 practitioner 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Pembroke, VA; Blacksburg, VA; Abingdon, VA |
| O20130130000257 | VA | Part B Supplier - Clinic/Group Practice | 9436303336 |
Receives reassigned benefits from 4 practitioners Practice locations: Galax, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
227 Hospital Dr
Galax, VA 24333-2228
Mailing address
PO Box 25866
Winston Salem, NC 27114-5866
Phone (336) 714-2500
Other providers in Galax, VA
- Bio-Medical Applications of Virginia, Inc.
- Don Howard Bivins
- Carlos Jesus Blattner
- Blue Ridge Eye Care Associates PLLC
- Blue Ridge Home Health Care
- Blue Ridge Support Services, LLC
- Blue Ridge Surgical Assoc., PC
- Blue Ridge Surgical Associates PC
- Body and Mindfully Healthy, LLC
- John William Bolen Jr.
All providers in Galax, VA · Obstetrics & Gynecology Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.