NPIMap

Organization Active NPI

Blue Plastic Surgery Center PLLC

  • Specialist
  • Mooresville, NC
National Provider Identifier
1598918526
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2005-1317 Issued in NC
Legal business name
BLUE PLASTIC SURGERY CENTER PLLC
Practice address
134 Professional Park Dr
Suite 200
Mooresville, NC 28117-5599
Phone
(704) 235-6610
Fax
(704) 235-6615
NPI assigned
Nov 4, 2008
Last updated
Jun 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Dr. Martin Luther Blue, M.D.NPI 1386692523
Title
Physician/Owner
Phone
(704) 235-6610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 2005-1317 NC Primary

Addresses

Primary practice location

134 Professional Park Dr
Suite 200
Mooresville, NC 28117-5599

Mailing address

134 Professional Park Dr
Suite 200
Mooresville, NC 28117-5599
Phone (704) 235-6610

National Provider Directory

National Provider Directory

Locations

134 Professional Park Dr
#2
Mooresville, NC 28117
Phone (704) 235-6610

134 Professional Park Dr
Ste 200
Mooresville, NC 28117
Phone (704) 235-6610

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1598918526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 PROFESSIONAL PARK DR",
            "address_2": "SUITE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175599",
            "telephone_number": "704-235-6610",
            "fax_number": "704-235-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 PROFESSIONAL PARK DR",
            "address_2": "SUITE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175599",
            "telephone_number": "704-235-6610",
            "fax_number": "704-235-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PLASTIC SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "704-235-6610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "2005-1317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.