Blue Ridge Regional Hospital, Inc
Organization Active NPI Rural Health Clinic/Center · Spruce Pine, NC
NPI 1790760213 · NPPES record last updated Nov 19, 2018
Key facts
- NPI
- 1790760213
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 343410 (NC)
- Legal business name
- BLUE RIDGE REGIONAL HOSPITAL, INC
- Practice address
- 189 Hospital Dr
Spruce Pine, NC 28777-3035 - Phone
- (828) 766-3555
- NPI assigned
- Dec 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Clint Stewart
- Title
- Regional Director
- Phone
- (828) 659-5196
Member of 1
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Feb 1, 2019 | Change of Ownership |
MH Blue Ridge Medical Center, LLLP |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | NC | ||
| Internal Medicine Physician |
207R00000X | NC | ||
| Pediatrics Physician |
208000000X | NC | ||
| Rural Health Clinic/Center | 261QR1300X | 343410 | NC | Yes |
| Physician Assistant |
363A00000X | NC | ||
| Nurse Practitioner |
363L00000X | NC |
Addresses
Primary practice location
189 Hospital Dr
Spruce Pine, NC 28777-3035
Mailing address
PO Box 602373
Charlotte, NC 28260-2373
Phone (828) 213-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0270B | Other | NC | BCBS |
Other names
- Mission Health Mauzy-Phillips Center
Other providers in Spruce Pine, NC
- Blue Ridge Regional Hospital Inc
- Blue Ridge Regional Hospital Inc
- Blue Ridge Regional Hospital Inc
- Blue Ridge Regional Hospital, Inc
- Blue Ridge Regional Hospital, Inc
- Blue Ridge Regional Hospital, Inc.
- Blue Ridge Regional Hospital, Inc.
- Blue Ridge Regional Hospital, Inc.
- Blue Ridge Regional Hospital, Inc.
- Blue Ridge Women'S Care
All providers in Spruce Pine, NC · Rural Health Clinic/Center 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 Nov 19, 2018. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.