NPIMap

Organization Active NPI

Blue Ridge Urological Assoc., PC

  • Urology Physician
  • Fishersville, VA
National Provider Identifier
1194746289
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101033256 Issued in VA
Legal business name
BLUE RIDGE UROLOGICAL ASSOC., PC
Practice address
70 Medical Center Cir
Suite 208
Fishersville, VA 22939-2273
Phone
(540) 345-3556
Fax
(540) 342-2193
NPI assigned
Jul 22, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Carie D Buckley III, MDNPI 1174511349
Title
President
Phone
(540) 345-3556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101033256 VA Primary

Addresses

Primary practice location

70 Medical Center Cir
Suite 208
Fishersville, VA 22939-2273

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other identifiers 5

IdentifierTypeStateIssuer
279040OtherVIANTHEM
440822OtherVAANTHEM
011346OtherVAANTHEM
011345OtherVAANTHEM
049990OtherVAANTHEM

National Provider Directory

National Provider Directory

Locations

70 Medical Ctr Dr
Ste 208
Fishersville, VA 22939
Phone (540) 332-5926

130 Walker St
Ste A
Lexington, VA 24450
Phone (540) 332-5926

610 Lee Hwy
#101
Verona, VA 24482

Interoperability endpoints

  • Direct secure messaging: brittanybarbarisi@bru.medalliesdirect.net
  • Direct secure messaging: charlesgillock@bru.medalliesdirect.net
  • Direct secure messaging: emilygreene@bru.medalliesdirect.net
  • Direct secure messaging: marcusmorra@bru.medalliesdirect.net
  • Direct secure messaging: stephenlegg@bru.medalliesdirect.net
  • Direct secure messaging: williamjones@bru.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1194746289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR",
            "address_2": "SUITE 208",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE UROLOGICAL ASSOC., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "CARIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-345-3556",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101033256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "279040",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "440822",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "011346",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "011345",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "049990",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.