The Blue Ridge Clemson Orthopaedic ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASF-068 Issued in SC

Legal business name

THE BLUE RIDGE CLEMSON ORTHOPAEDIC ASC LLC

Practice address

10630 Clemson Blvd Ste 200
Seneca, SC 29678-4545

Phone

(864) 482-5100

Fax

(864) 482-9100

NPI assigned

Feb 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Blue Ridge Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Listed as

Blue Ridge Surgery CenterCCN 42C0001044

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Greenville Health Corporation

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
  • NPI 1689046294

  Member Of

  NPD member

Locations

Practitioners 1

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

• Patrick Sean McCallum, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Seneca, SC
  • NPI 1356300040
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1477526689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD STE 200",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784545",
            "telephone_number": "864-482-5100",
            "fax_number": "864-482-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 CLEMSON BLVD STE 200",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784545",
            "telephone_number": "864-482-5100",
            "fax_number": "864-482-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLUE RIDGE CLEMSON ORTHOPAEDIC ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": "ASF-068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC040",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Ridge Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Seneca, SC
• Ambulatory Surgical Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.