Blue Telepsych Urgent Care

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

BLUE TELEPSYCH URGENT CARE

Doing business as

Blue PsychCare

Practice address

8406 Fiddlestick Way
Wilmington, NC 28412-3394

Phone

(910) 523-1825

NPI assigned

Aug 28, 2020

Last updated

Aug 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ray Jazayeri

Title

President

Phone

(910) 523-1825

Specialties & licenses 1

Addresses

Other names 1

• Blue PsychCare Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anna-Margaret Chauncey Jazayeri, P.A.-C

  • Physician Assistant
  • Hatteras, NC
  • NPI 1487600631
  Medicare reassignment

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1740893734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8406 FIDDLESTICK WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123394",
            "telephone_number": "910-523-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8406 FIDDLESTICK WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123394",
            "telephone_number": "910-523-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3953B Market St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284031403",
            "country_code": "US",
            "telephone_number": "910-523-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE TELEPSYCH URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "JAZAYERI",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-523-1825"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue PsychCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blossom Home Care LLC
• Yolanda Naomi Blount Wood, LPC
• Janelle Bludworth, PA-C
• Blue Horseshoe Healthcare Inc
• Blue Lotus Counseling, PLLC
• Tony Blue, MD
• Bluewater Surgical, PLLC
• Zachary Allen Blumenkehl
• Edward Boris Blyther, LCSW
• Nolan Bodah, D.D.S.

• Medical Specialty Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.

Verify at the official NPI Registry.