Blue Ridge Surgical Group, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9500690 Issued in NC

Legal business name

BLUE RIDGE SURGICAL GROUP, PA

Practice address

838 State Farm Road, Suite 1
Boone, NC 28607

Phone

(828) 268-0688

Fax

(828) 268-0413

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Sherri Boothe

Title

Office Manager

Phone

(828) 268-0688

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730112434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 STATE FARM ROAD, SUITE 1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-268-0688",
            "fax_number": "828-268-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 STATE FARM ROAD, SUITE 1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-268-0688",
            "fax_number": "828-268-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE SURGICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOOTHE",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-268-0688"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "9500690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0267W",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890267W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Home Care
• Blue Ridge Integrative Health, PC
• Blue Ridge Pediatric & Adolescent Medicine, Inc
• Blue Ridge Physcial Therapy
• Blue Ridge Speech Therapy
• Cynthia B Blust, SLP
• Susan M. Bobo, MA, LPC
• Thomas J Boeve, M.D.
• Brittney Boggs, LCSWA
• Taylar Bolds, MA, MSW

• Surgery Physician in Boone, NC
• Providers in Boone, NC by specialty
• Surgery Physician in North Carolina

• 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.