Blue Ridge Healthcare Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.

Doing business as

Hildebran-Icard Medical Care Center

Practice address

517 Main Ave. West
Hildebran, NC 28637

Phone

(828) 397-5561

Fax

(828) 397-3226

NPI assigned

Oct 11, 2006

Last updated

Mar 5, 2008By 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

Robert Fritts

Title

SVP/Cfo

Phone

(828) 580-5455

Specialties & licenses 1

Addresses

Other names 1

• Hildebran-Icard Medical Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1891883989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 MAIN AVE. WEST",
            "city": "HILDEBRAN",
            "state": "NC",
            "postal_code": "28637",
            "telephone_number": "828-397-5561",
            "fax_number": "828-397-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 MAIN AVE. WEST",
            "city": "HILDEBRAN",
            "state": "NC",
            "postal_code": "28637",
            "telephone_number": "828-397-5561",
            "fax_number": "828-397-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "FRITTS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SVP/CFO",
        "authorized_official_telephone_number": "828-580-5455"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hildebran-Icard Medical Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Hildebran, NC
• Providers in Hildebran, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.