Blue Ridge Dermatology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101028429 Issued in VA

Legal business name

BLUE RIDGE DERMATOLOGY, P.C.

Practice address

1151 13TH St
Waynesboro, VA 22980-4432

Phone

(540) 949-6934

Fax

(540) 932-7118

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Tomita Lawrence

Title

Practice Manager

Phone

(540) 949-5470

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1821030461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 13TH ST",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229804432",
            "telephone_number": "540-949-6934",
            "fax_number": "540-932-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 13TH ST",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229804432",
            "telephone_number": "540-949-6934",
            "fax_number": "540-932-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "TOMITA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "540-949-5470"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101028429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "111868",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "099634",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bionic Innovations LLC
• Rachel Ann Blair, NP
• Barbara Blevins, SLP
• Robert H Blinn, PH.D.
• Jennifer Blosser, FNP
• Blue Ridge Foot & Ankle Clinic, PLC
• Melinda Bosserman, OTR/L
• Penny Orr Bowles, RPH
• Bowman Family Dentistry PLLC
• Kenneth Darrell Bowman, DDS

• Specialist in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.