Thomas R. Blackburn, MD, PA

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

14614 Issued in NC

Legal business name

THOMAS R. BLACKBURN, MD, PA

Doing business as

Blue Ridge Radiology

Practice address

201 E Parker Rd
Morganton, NC 28655-5107

Phone

(828) 433-1206

Fax

(828) 433-0667

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Reid Blackburn, MD

Title

Radiologist

Phone

(704) 482-0386

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BLUE RIDGE RADIOLOGY Doing business as

Locations

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1548305097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 KINGS CIR",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281506030",
            "telephone_number": "704-482-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E PARKER RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555107",
            "telephone_number": "828-433-1206",
            "fax_number": "828-433-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R. BLACKBURN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "704-482-0386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NC",
            "license": "14614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE NO.",
            "identifier": "14614",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE RIDGE RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiology Clinic/Center in Morganton, NC
• Providers in Morganton, NC by specialty
• Radiology Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.