Charlottesville Area Retirement Service, Inc.

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CHARLOTTESVILLE AREA RETIREMENT SERVICE, INC.

Doing business as

Blue Ridge PACE

Practice address

1335 Carlton Ave
Charlottesville, VA 22902-5813

Phone

(434) 529-1300

Fax

(434) 327-4100

NPI assigned

Jun 28, 2013

Organization subpart

Yes

Parent organization

RIVERSIDE RETIREMENT SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Mr. Craig Connor

Title

VP Pace

Phone

(757) 234-8428

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Blue Ridge PACE Doing business as

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

CLIA laboratory certificates

Part of

Riverside Retirement Services Inc

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396137600000",
    "number": "1407296957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 OLD DENBIGH BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236022017",
            "telephone_number": "757-875-2050",
            "fax_number": "757-875-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 CARLTON AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025813",
            "telephone_number": "434-529-1300",
            "fax_number": "434-327-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTESVILLE AREA RETIREMENT SERVICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE RETIREMENT SERVICES, INC.",
        "enumeration_date": "2013-06-28",
        "last_updated": "2014-03-30",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "VP PACE",
        "authorized_official_telephone_number": "757-234-8428",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CONTRACT NUMBER",
            "identifier": "H3473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna Charlebois, ACNP
• Eric Charles, M.D.
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• Charlottesville Area Dental Access Inc (Community Children's Dental Center)
• Charlottesville Blue Ridge Dental, PLC
• Charlottesville Care Center LLC (Charlottesville Health & Rehabilitation Center)
• Charlottesville City Schools
• Charlottesville Counseling Group
• Charlottesville Dental Associates

• PACE Provider Organization in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• PACE Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.