Blue River Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLUE RIVER HEALTHCARE, INC

Practice address

2705 Clay St
Vicksburg, MS 39183-3130

Phone

(601) 218-7880

NPI assigned

Mar 24, 2017

Last updated

Mar 24, 2017By 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

Joyce Blue

Title

Ceo

Phone

(601) 218-7880

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1750812392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820472",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391820472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 CLAY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833130",
            "telephone_number": "601-218-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIVER HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-218-7880"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.