NPIMap

Organization Active NPI

Blue Ridge Orthopaedic Associates PC

  • Orthopaedic Surgery Physician
  • Warrenton, VA
National Provider Identifier
1508959701
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
C00617
Legal business name
BLUE RIDGE ORTHOPAEDIC ASSOCIATES PC
Practice address
52 W. Shirley Ave
Warrenton, VA 20186-3008
Phone
(540) 347-9220
Fax
(540) 347-0492
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Mr. Jeffry M Hollis, C.P.A.
Title
C.E.O.
Phone
(540) 347-9220

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X C00617 Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

52 W. Shirley Ave
Warrenton, VA 20186-3008

Mailing address

52 W. Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

Other names 1

  • Blue Ridge Orthopaedic & Spine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040510001256 VA Part B Supplier - Clinic/Group Practice 6800885310 Receives reassigned benefits from 55 practitioners
Practice locations: Culpeper, VA; Warrenton, VA; Gainesville, VA
O20100930025454 VA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6800885310 Practice locations: Warrenton, VA
O20151015001402 DC Part B Supplier - Clinic/Group Practice 6800885310 Receives reassigned benefits from 2 practitioners
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

14370 Lee Hwy
Ste 102
Gainesville, VA 20155
Phone (703) 743-2814

225 Oak Springs Dr
Ste 201
Warrenton, VA 20186
Phone (540) 878-5408

328 Hospital Dr
Warrenton, VA 20186

Practitioners & affiliated clinicians

Practitioners 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1508959701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W. SHIRLEY AVE",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W. SHIRLEY AVE",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE ORTHOPAEDIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "HOLLIS",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "540-347-9220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.A."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": "C00617",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Orthopaedic & Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warrenton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.