Blue Ridge Internal Medicine Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1804 Issued in WV

Legal business name

BLUE RIDGE INTERNAL MEDICINE INC.

Practice address

407 12TH Street Ext
Princeton, WV 24740-2300

Phone

(304) 487-0232

Fax

(304) 487-0285

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Todd Andrew Smith, DO

Title

President

Phone

(304) 487-0232

Specialties & licenses 1

Addresses

Other identifiers 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Blue Ridge Internal Medicine Inc.

  • Clinical Medical Laboratory
  • Princeton, WV
  • NPI 1558557090
  NPPES parent name

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1285729178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5065",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247405065",
            "telephone_number": "304-487-0232",
            "fax_number": "304-487-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402300",
            "telephone_number": "304-487-0232",
            "fax_number": "304-487-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE INTERNAL MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-487-0232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "1804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003706",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Sue Blaylock
• Samantha Blaylock
• Melissa Bledsoe, BS
• Susan Fawn Blevins, FNP
• Ontashia Blizzard
• Blue Ridge Internal Medicine Inc.
• Bluefield Gastroenterology PLLC
• Bluefield Mental Health Center, PC
• Bluestone Health Association, Inc.
• Bluestone Health Association, Inc.

• All providers in Princeton, WV
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.