Blue Ridge Pediatrics LLP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BLUE RIDGE PEDIATRICS LLP

Practice address

3124 Blue Ridge Rd
Suite 102
Raleigh, NC 27612

Phone

(919) 782-0021

Fax

(919) 571-0825

NPI assigned

Nov 3, 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

Dr. Nicholas Joseph Davanzo, MDNPI 1700984812

Title

General Partner

Phone

(919) 782-0021

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Nicholas Joseph D'Avanzo, M.D.

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1700984812
  Authorized official Same address or phone
• Lorven Michael Edralin, M.D.

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1316385982
  NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942389838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 BLUE RIDGE RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-782-0021",
            "fax_number": "919-571-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 BLUE RIDGE RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-782-0021",
            "fax_number": "919-571-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE PEDIATRICS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVANZO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "919-782-0021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Family Physicians, PLLC
• Blue Ridge Medical Group PA
• Blue Ridge OB/GYN Associates PLLC
• Blue Ridge of Raleigh LLC (Blue Ridge Health Care Center)
• Blue Ridge of Raleigh, LLC (Blue Ridge Health Care Center)
• Blue Ridge Psychological Services, P.a.
• Blue Ridge Sedation Associates LLC
• Blue River Health Services, PLLC
• Debra L Blue, MD
• Kiara Nicole Blue, LCSWA

• Pediatrics Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatrics 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.