NPIMap

Organization Active NPI

Blue Ridge Community Health Services, Inc.

Doing business as Blue Ridge Health-Meridian 69 North Broad

  • Federally Qualified Health Center (FQHC)
  • Brevard, NC
National Provider Identifier
1396414488
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BLUE RIDGE COMMUNITY HEALTH SERVICES, INC.
Doing business as
Blue Ridge Health-Meridian 69 North Broad
Practice address
69 N Broad St
Brevard, NC 28712-3725
Phone
(828) 883-2708
Fax
(828) 883-2709
NPI assigned
Sep 10, 2021
Last updated
Sep 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Tammy R Greenwell
Title
Ceo
Phone
(828) 233-2284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

69 N Broad St
Brevard, NC 28712-3725

Mailing address

220 5TH Ave E
Hendersonville, NC 28792-4377
Phone (828) 692-4289

Other names 1

  • Blue Ridge Health-Meridian 69 North Broad Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211208000497 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173434743 Practice locations: Brevard, NC
O20220104001963 NC Part B Supplier - Clinic/Group Practice 3173434743 Receives reassigned benefits from 56 practitioners
Practice locations: Brevard, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396414488. Details of each certification follow.

Federally qualified health center certification: CCN 861843

Legal name
BLUE RIDGE COMMUNITY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 12, 2021
Last certification
Nov 12, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 3, 1963 in NC
Enrollment address
69 N Broad St
Brevard, NC 28712-3725

Other NPIs with the same Medicare PAC ID 21

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 21

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2048706Blue Ridge Health - Meridian 69 North North69 North Broad Street, Brevard, NC 28712Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory

Locations

110 Chadwick Square Ct
Ste A
Hendersonville, NC 28739
Phone (828) 617-9122

209 Hospital Dr
Highlands, NC 28741
Phone (828) 482-6160

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marilyn W Tatham Individual W-2 Managing EmployeeProvider Enrollment Manager Nov 1, 2021
Tammy Renee Greenwell Individual Corporate DirectorBoard of Directors Aug 28, 2025
W-2 Managing EmployeeAd;Ceo Aug 28, 2025

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1396414488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 5TH AVE E",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287924377",
            "telephone_number": "828-692-4289",
            "fax_number": "828-883-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 N BROAD ST",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123725",
            "telephone_number": "828-883-2708",
            "fax_number": "828-883-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "GREENWELL",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-233-2284"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Health-Meridian 69 North Broad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Ridge Health-Meridian 69 North Broad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brevard, NC

Sources for this page

Verify at the official NPI Registry.