Blue Ridge Family Physicians, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

108015 Issued in NC

Legal business name

BLUE RIDGE FAMILY PHYSICIANS, PLLC

Practice address

2605 Blue Ridge Rd
Suite 300
Raleigh, NC 27607-6475

Phone

(919) 787-3448

Fax

(919) 232-0006

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kirsten H. Avery, MD

Title

Physician

Phone

(919) 787-3448

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1356433155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BLUE RIDGE RD",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076475",
            "telephone_number": "919-787-3448",
            "fax_number": "919-232-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 BLUE RIDGE RD",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076475",
            "telephone_number": "919-787-3448",
            "fax_number": "919-232-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE FAMILY PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "919-787-3448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "108015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013NA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Monkey Counseling, PLLC
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• Blue Ram Home Care, LLC
• Blue Ridge Day Surgery Center, LP
• Blue Ridge Dermatology Associates
• Blue Ridge Medical Group PA
• Blue Ridge OB/GYN Associates PLLC
• Blue Ridge of Raleigh LLC
• Blue Ridge of Raleigh, LLC
• Blue Ridge Pediatrics LLP

• All providers in Raleigh, NC
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.