Blue Ridge Pediatrics PLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101028473 Issued in VA

Legal business name

BLUE RIDGE PEDIATRICS PLC

Practice address

401 Commerce Rd
Suite #421
Staunton, VA 24401-4446

Phone

(540) 885-8143

Fax

(540) 885-9809

NPI assigned

Jul 15, 2006

Last updated

Aug 22, 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

Mrs. Beth A. Brower

Title

Office Manager

Phone

(540) 885-8144

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Alexander Randolph Thomas

  • Pediatrics Physician
  • Staunton, VA
  • NPI 1962553545
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831115427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE RD",
            "address_2": "SUITE #421",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244014446",
            "telephone_number": "540-885-8143",
            "fax_number": "540-885-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 COMMERCE RD",
            "address_2": "SUITE #421",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244014446",
            "telephone_number": "540-885-8143",
            "fax_number": "540-885-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE PEDIATRICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-885-8144",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101028473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP OPTIMA",
            "identifier": "OPTIMA",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP SH  COVENTRY",
            "identifier": "226661",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ANTHEM",
            "identifier": "385713",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Mora Blalock, PHARM.D.
• Brett Blevins, PSY.ED
• Blue Ridge Family Medicine PLC
• Blue Ridge Footcare and Surgery PLC
• Blue Ridge Neuropsychology PC
• Blue Ridge Radiologists Inc.
• Body Ease Physical Therapy Centre
• Jeffrey Bonacci, M.D.
• Alexis Borja
• Demetri Antonio Boston, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.