NPIMap

Organization Active NPI

Blue Ridge Healthcare Medical Group, Inc.

Doing business as Blue Ridge Geriatrics

  • Geriatric Medicine (Family Medicine) Physician
  • Morganton, NC
National Provider Identifier
1407203052
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Doing business as
Blue Ridge Geriatrics
Practice address
2209 S Sterling St Ste 330
Morganton, NC 28655-4093
Phone
(828) 580-5706
Fax
(828) 580-8033
NPI assigned
May 24, 2016
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Patricia Moll
Title
SVP-Cfo
Phone
(828) 580-5003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

2209 S Sterling St Ste 330
Morganton, NC 28655-4093

Mailing address

2209 S Sterling St Ste 330
Morganton, NC 28655-4093
Phone (828) 580-5706

Other names 1

  • Blue Ridge Geriatrics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000601 NC Part B Supplier - Clinic/Group Practice 9436159712 Receives reassigned benefits from 346 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Morganton, NC; Marion, NC; Morgantown, NC; Nebo, NC; Valdese, NC; Winterville, NC; Connelly Springs, NC; Granite Falls, NC…

National Provider Directory

National Provider Directory
Tax ID family
Blue Ridge Healthcare Medic36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

2209 S Sterling St
Ste 330
Morganton, NC 28655
Phone (828) 580-5706

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": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1407203052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 S STERLING ST STE 330",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554093",
            "telephone_number": "828-580-5706",
            "fax_number": "828-580-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 S STERLING ST STE 330",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554093",
            "telephone_number": "828-580-5706",
            "fax_number": "828-580-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "MOLL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "SVP-CFO",
        "authorized_official_telephone_number": "828-580-5003"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Blue Ridge Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Ridge Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.