Blue Ridge Family Practice Assoc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE RIDGE FAMILY PRACTICE ASSOC

Practice address

243 Jones Cove Rd
Clyde, NC 28721-9483

Phone

(828) 627-3411

Fax

(828) 627-6607

NPI assigned

Dec 19, 2005

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

Donald R Teater, MD

Title

Pres Corp

Phone

(828) 627-3411

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932185204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 JONES COVE RD",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219483",
            "telephone_number": "828-627-3411",
            "fax_number": "828-627-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 JONES COVE RD",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219483",
            "telephone_number": "828-627-3411",
            "fax_number": "828-627-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE FAMILY PRACTICE ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TEATER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRES CORP",
        "authorized_official_telephone_number": "828-627-3411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890137L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Bidikov
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• Blue Ridge Dermatology PA
• Blue Ridge Ultrasound, Inc.
• Bodnar & Wyatt, PLLC (Cataloochee Dental Group)
• Jason Bodnar, DMD
• Harold Breakey
• Colin James Bridger, MPT

• Family Medicine Physician in Clyde, NC
• Providers in Clyde, 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 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.