Blue Ridge Physical Medicine

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

BLUE RIDGE PHYSICAL MEDICINE

Practice address

4582 Franklin Rd SW
Roanoke, VA 24014-5144

Phone

(540) 772-8052

Fax

(540) 772-4508

NPI assigned

Sep 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca W Tanner

Title

Owner

Phone

(540) 772-8052

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Amin M. Karkain, PA-C

  • Physician Assistant
  • Stafford, VA
  • NPI 1518938299
  NPD (past)
• Tracy Kletzing, PA

  • Medical Physician Assistant
  • Christiansburg, VA
  • NPI 1073772273
  NPD (past)
• Sandra Dee Vigh, PT

  • Specialist
  • Roanoke, VA
  • NPI 1740454461
  NPD (past)

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1710173679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4582 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145144",
            "telephone_number": "540-772-8052",
            "fax_number": "540-772-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145144",
            "telephone_number": "540-772-8052",
            "fax_number": "540-772-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-772-8052",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801510",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Mind and Wellness
• Blue Ridge Mind and Wellness PLLC
• Blue Ridge Optical
• Blue Ridge Optical
• Blue Ridge Optical
• Blue Ridge Telehealth
• Blue Ridge Urogynecology, Inc
• Blue Ridge Vascular & Endovascular Institute LLC
• Blue Ridge Wound Care LLC
• Logan D Blunk, D.O.

• All providers in Roanoke, VA
• Pain Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.