Blue Ridge Healthcare Medical Group Inc
Organization Active NPI Emergency Medicine Physician · Morganton, NC
NPI 1811244726 · NPPES record last updated Apr 9, 2025
Key facts
- NPI
- 1811244726
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- BLUE RIDGE HEALTHCARE MEDICAL GROUP INC
- Practice address
- 695 W Fleming Dr
Morganton, NC 28655-4450 - Phone
- (828) 580-3278
- Fax
- (828) 580-3279
- NPI assigned
- Aug 9, 2012
- Organization subpart
- No
Authorized official
- Name
- Patricia Moll
- Title
- SVP-Cfo
- Phone
- (828) 580-5003
Practitioners 7
-
Morgan Hollingsworth Crow, FNP-C
-
Robert Edward Johnson, PA-C
-
Steven Reagan, NP
-
Rahul Sampath, M.D
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2070418 | Unc Health Blue Ridge Urgent Care | Certificate of waiver | Dec 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070110000601 | NC | Part B Supplier - Clinic/Group Practice | 9436159712 |
Receives reassigned benefits from 346 practitioners This NPI is an additional NPI on the enrollment Practice locations: Morganton, NC; Marion, NC; Morgantown, NC; Nebo, NC; Valdese, NC; Winterville, NC; Connelly Springs, NC; Granite Falls, NC… |
National Provider Directory
Locations
695 W Fleming Dr
Morganton, NC 28655
Phone (828) 580-3278
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Family Medicine Physician |
207Q00000X | |||
| General Practice Physician |
208D00000X | |||
| Urgent Care Clinic/Center | 261QU0200X |
Addresses
Primary practice location
695 W Fleming Dr
Morganton, NC 28655-4450
Mailing address
695 W Fleming Dr
Morganton, NC 28655-4450
Phone (828) 580-3278
Other names
- Blue Ridge Urgent Care
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Morganton, NC
- Blue Ridge Healthcare Hospitals, Inc.
- Blue Ridge Healthcare Hospitals, Inc.
- Blue Ridge Healthcare Hospitals, Inc.
- Blue Ridge Healthcare Medical Group Inc
- Blue Ridge Healthcare Medical Group Inc
- Blue Ridge Healthcare Medical Group Inc
- Blue Ridge Healthcare Medical Group, Inc
- Blue Ridge Healthcare Medical Group, Inc
- Blue Ridge Healthcare Medical Group, Inc
- Blue Ridge Healthcare Medical Group, Inc.
All providers in Morganton, NC · Emergency Medicine Physician 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 Apr 9, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.