Organization Active NPI

Blue Ridge Neurology Associates P.C.

  • Specialist
  • Kingsport, TN
National Provider Identifier
1639190846
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD26480 Issued in TN
Legal business name
BLUE RIDGE NEUROLOGY ASSOCIATES P.C.
Practice address
2012 Brookside Dr
Ste. 8
Kingsport, TN 37660-4645
Phone
(423) 224-4183
Fax
(423) 224-4180
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael S Dew, M.D.NPI 1093701427
Title
Doctor
Phone
(423) 224-4183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD26480 TN Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD20022 TN

Addresses

Primary practice location

2012 Brookside Dr
Ste. 8
Kingsport, TN 37660-4645

Mailing address

2012 Brookside Dr
Ste. 8
Kingsport, TN 37660-4645
Phone (423) 224-4183

National Provider Directory

National Provider Directory

Locations

2012 Brookside Dr
Ste 8
Kingsport, TN 37660
Phone (423) 224-3125

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639190846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 BROOKSIDE DR",
            "address_2": "STE. 8",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604645",
            "telephone_number": "423-224-4183",
            "fax_number": "423-224-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 BROOKSIDE DR",
            "address_2": "STE. 8",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604645",
            "telephone_number": "423-224-4183",
            "fax_number": "423-224-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE NEUROLOGY ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "423-224-4183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD26480",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD20022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.