Organization Active NPI

Blue Ridge Orthopaedic Assoc, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Anderson, SC
National Provider Identifier
1376569343
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
BLUE RIDGE ORTHOPAEDIC ASSOC, PA
Practice address
100 Healthy Way
Suite 1200
Anderson, SC 29621-7916
Phone
(864) 482-6000
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Ms. Jo Stokes
Title
Administrator
Phone
(864) 482-6165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

100 Healthy Way
Suite 1200
Anderson, SC 29621-7916

Mailing address

10630 Clemson Blvd
Suite 100
Seneca, SC 29678-4545
Phone (864) 260-9910

Other identifiers 1

IdentifierTypeStateIssuer
PA4584MedicaidSC

Other names 1

  • Blue Ridge Orthopaedics Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1376569343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD",
            "address_2": "SUITE 100",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784545",
            "telephone_number": "864-260-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HEALTHY WAY",
            "address_2": "SUITE 1200",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296217916",
            "telephone_number": "864-482-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE ORTHOPAEDIC ASSOC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "864-482-6165",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA4584",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Orthopaedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.