Active NPI
Blue Ridge Healthcare Medical Group, Inc.
- Nephrology Physician
- Morganton, NC
National Provider Identifier
1679735112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 200300065
- Legal business name
- BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
- Practice address
- 352 E Parker Rd Ste B
Suite a
Morganton, NC 28655-5122 - Phone
- (828) 580-3250
- Fax
- (828) 580-3251
- NPI assigned
- Jun 26, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert G Fritts
- Title
- SVP-Cfo
- Phone
- (828) 580-5545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 200300065 | NC | Primary |
Addresses
Primary practice location
352 E Parker Rd Ste B
Suite a
Morganton, NC 28655-5122
Mailing address
PO Box 601076
Charlotte, NC 28260-1076
Phone (828) 580-3250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5950781 | Medicaid | NC |
Other names 1
- Blue Ridge Nephrology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070110000601 | NC | Part B Supplier - Clinic/Group Practice | 9436159712 |
Receives reassigned benefits from 346 practitioners This NPI is an additional NPI on the enrollment Practice locations: Morganton, NC; Marion, NC; Morgantown, NC; Nebo, NC; Valdese, NC; Winterville, NC; Connelly Springs, NC; Granite Falls, NC… |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1367452800000",
"number": "1679735112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601076",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601076",
"telephone_number": "828-580-3250",
"fax_number": "828-580-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 E PARKER RD STE B",
"address_2": "SUITE A",
"city": "MORGANTON",
"state": "NC",
"postal_code": "286555122",
"telephone_number": "828-580-3250",
"fax_number": "828-580-3251"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-06-26",
"last_updated": "2013-05-02",
"status": "A",
"authorized_official_last_name": "FRITTS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "SVP-CFO",
"authorized_official_telephone_number": "828-580-5545"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "NC",
"license": "200300065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5950781",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Blue Ridge Nephrology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Morganton, NC
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.