Blue Ridge Healthcare Medical Group, Inc
Organization Active NPI Hematology (Internal Medicine) Physician · Connelly Springs, NC
NPI 1699197012 · NPPES record last updated Mar 14, 2025
Key facts
- NPI
- 1699197012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology (Internal Medicine) Physician 207RH0000X
- License
- 2009-00695 (NC)
- Legal business name
- BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC
- Practice address
- 720 Malcolm Blvd
Suite 200
Connelly Springs, NC 28612-7920 - Phone
- (828) 580-7536
- Fax
- (828) 580-7537
- NPI assigned
- Jan 21, 2014
- Organization subpart
- No
Authorized official
- Name
- Patricia Moll
- Title
- SVP-Cfo
- Phone
- (828) 580-5003
Corporate family (same tax ID) 35
Practitioners 14
-
Harpreet Singh Bhalla, M.D.
-
Marc F Guerra, M.D.
-
Kathleen M Lappin, PA-C
-
Caroline Kaye Lynn, NP-C
-
Wenimar D. Salvador, M.D.
-
Robert William Stout, RPA-C
-
Andres Scott Carden, M.D.
-
Amy Smith Ende, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| 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
- Tax ID family
- Blue Ridge Hlthcare Med GRP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician |
207RH0000X | 2009-00695 | NC | Yes |
Addresses
Primary practice location
720 Malcolm Blvd
Suite 200
Connelly Springs, NC 28612-7920
Mailing address
720 Malcolm Blvd
Suite 200
Connelly Springs, NC 28612-7920
Phone (828) 580-7536
Other names
- The Cancer Center at Blue Ridge Valdese
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Connelly Springs, NC
- Sharalyn C Anthony
- Sameer Mirza Baig
- Michael Brian Bauer
- Kaitlyn Brooke Berry
- John Clements Betancourt
- 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.
All providers in Connelly Springs, NC · Hematology (Internal Medicine) Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.