Active NPI
Roanoke Surgery Center, LP
Doing business as Blue Ridge Surgery Center
- Ambulatory Surgical Clinic/Center
- Salem, VA
National Provider Identifier
1205869211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- OH697
- Legal business name
- ROANOKE SURGERY CENTER, LP
- Doing business as
- Blue Ridge Surgery Center
- Practice address
- 1802 Braeburn Dr
Salem, VA 24153-7357 - Phone
- (540) 725-4533
- Fax
- (540) 725-4543
- NPI assigned
- Jul 10, 2006
- Last updated
- Sep 9, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David McKnight
- Title
- VP/Cfo
- Phone
- (972) 789-2816
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | OH697 | VA | Primary |
Addresses
Primary practice location
1802 Braeburn Dr
Salem, VA 24153-7357
Mailing address
1802 Braeburn Dr
Salem, VA 24153-7357
Phone (540) 725-4533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010276039 | Medicaid | VA |
Other names 1
- Blue Ridge Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060425000327 | VA | Part B Supplier - Ambulatory Surgical Center | 7719997568 | Practice locations: Salem, VA |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Roanoke Surgery Center LP
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0669277 | Roanoke Surgery Center, LP Dba Blue Ridge | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400
Practitioners & affiliated clinicians
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.
-
- Anesthesiology Physician
- Salem, VA
- NPI 1972529410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788912000000",
"number": "1205869211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 BRAEBURN DR",
"city": "SALEM",
"state": "VA",
"postal_code": "241537357",
"telephone_number": "540-725-4533",
"fax_number": "540-725-4543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 BRAEBURN DR",
"city": "SALEM",
"state": "VA",
"postal_code": "241537357",
"telephone_number": "540-725-4533",
"fax_number": "540-725-4543"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROANOKE SURGERY CENTER, LP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A",
"authorized_official_last_name": "MCKNIGHT",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "VP/CFO",
"authorized_official_telephone_number": "972-789-2816"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "VA",
"license": "OH697",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010276039",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Blue Ridge Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salem, VA
- Roanoke County Board of Supervisors
- Roanoke Endodontics
- Roanoke Orthopaedic Center, Inc. (Roanoke Orthopaedic Center)
- Roanoke Physician Services, LLC
- Roanoke Refuge LLC
- Roanoke Valley Center for Sight LLC
- Roanoke Valley Center for Sight, LLC
- Roanoke Valley Ear, Nose, and Throat, P.C.
- Melissa Roberts
- Lisa Gerrard Rochford, PH.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.