Blue Ridge Healthcare Montgomery LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BLUE RIDGE HEALTHCARE MONTGOMERY LLC

Practice address

4490 Virginia Loop Rd
Montgomery, AL 36116-3448

Phone

(334) 281-6826

NPI assigned

Oct 27, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Administrator Administrator

Title

Administrator

Phone

(334) 281-6826

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553472000000",
    "number": "1407368608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 VIRGINIA LOOP RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361163448",
            "telephone_number": "334-281-6826",
            "fax_number": "334-281-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 VIRGINIA LOOP RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361163448",
            "telephone_number": "334-281-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE MONTGOMERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2019-03-25",
        "status": "A",
        "authorized_official_last_name": "ADMINISTRATOR",
        "authorized_official_first_name": "ADMINISTRATOR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-281-6826",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.