Blue Mountain Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BLUE MOUNTAIN DIAGNOSTICS LLC

Practice address

10 Enterprise Blvd Ste 206
Greenville, SC 29615-3554

Phone

(864) 263-3302

NPI assigned

Oct 1, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey David Alexander

Title

Owner

Phone

(864) 907-8820

Specialties & licenses 1

Addresses

Other names 1

• Blue Mountain Diagnostics, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeff David Alexander

  • Clinical Medical Laboratory
  • Greenville, SC
  • NPI 1568078509
  NPD

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1346847522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ENTERPRISE BLVD STE 206",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153554",
            "telephone_number": "864-263-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ENTERPRISE BLVD STE 206",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153554",
            "telephone_number": "864-263-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-907-8820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Mountain Diagnostics, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Blue Mountain Diagnostics, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Greenville, SC
• Providers in Greenville, SC by specialty
• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.

Verify at the official NPI Registry.