Organization Active NPI

Blue Ridge Footcare and Surgery PLC

  • Podiatrist
  • Staunton, VA
National Provider Identifier
1336330620
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
BLUE RIDGE FOOTCARE AND SURGERY PLC
Practice address
111 Fairway LN Ste 100
Staunton, VA 24401-3576
Phone
(540) 885-8891
Fax
(540) 885-0016
NPI assigned
Aug 5, 2007
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Theodore McKee, DPMNPI 1306888417
Title
Owner
Phone
(540) 885-8891

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary
Foot & Ankle Surgery Podiatrist 213ES0103X
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

111 Fairway LN Ste 100
Staunton, VA 24401-3576

Mailing address

111 Fairway LN Ste 100
Staunton, VA 24401-3576
Phone (540) 885-8891

Other identifiers 4

IdentifierTypeStateIssuer
1336330620OtherVANPI GROUP
1336330620MedicaidVA
DG6187OtherVAMEDICARE RR GROUIP
1588847982OtherVANPI GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080125000518 VA Part B Supplier - Clinic/Group Practice 3779665021 Receives reassigned benefits from 2 practitioners
Practice locations: Staunton, VA
O20100930072220 VA DME Supplier - Physician - Podiatry 3779665021 Practice locations: Staunton, VA

National Provider Directory

National Provider Directory

Locations

111 Fairway Ln
Staunton, VA 24401

Practitioners & affiliated clinicians

Practitioners 3

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1336330620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FAIRWAY LN STE 100",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244013576",
            "telephone_number": "540-885-8891",
            "fax_number": "540-885-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FAIRWAY LN STE 100",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244013576",
            "telephone_number": "540-885-8891",
            "fax_number": "540-885-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE FOOTCARE AND SURGERY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-885-8891",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUIP",
            "identifier": "DG6187",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1588847982",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.