Blue Ridge Podiatry Associates

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103000391 Issued in VA

Legal business name

BLUE RIDGE PODIATRY ASSOCIATES

Practice address

390 S Main St Ste 103
Rocky Mount, VA 24151-1767

Phone

(540) 483-7933

Fax

(540) 463-9454

NPI assigned

Oct 19, 2005

Last updated

Nov 22, 2010By 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. John Larry Clements, D.P.M

Title

President

Phone

(540) 885-8891

Specialties & licenses 3

Addresses

Other identifiers 6

Locations

Practitioners 4

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.

• John R Clements, D.P.M.

  • Podiatrist
  • Roanoke, VA
  • NPI 1629012208
  NPD (past)
• Dean V Dimotsis, D.P.M.

  • Podiatrist
  • Waynesboro, VA
  • NPI 1760426357
  NPD (past)
• Jennifer Anne Keller, DPM

  • Podiatrist
  • Roanoke, VA
  • NPI 1144290784
  NPD (past)
• Theodore B McKee, D.P.M.

  • Podiatrist
  • Staunton, VA
  • NPI 1306888417
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1952390221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4205",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272894205",
            "telephone_number": "336-623-4545",
            "fax_number": "206-333-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S MAIN ST STE 103",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241511767",
            "telephone_number": "540-483-7933",
            "fax_number": "540-463-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE PODIATRY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-885-8891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000371",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103300877",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC STAUNTON LOCATION",
            "identifier": "0518620001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CM9184",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301747",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC LEXINGTON LOCATION",
            "identifier": "0518620002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301283",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301208",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammed Bermo, MD
• Bio-Medical Applications of Virginia, Inc. (Fresenius Medical Care Franklin County)
• Kristen E Birkmeier, PT
• Rachel Moline Blankenship, CRNA
• Blue Ridge Heart Care PC
• Kathleen Patt Bogacz, MD
• Shawn H Boggiano
• Craig L Bookout, MD
• Luke Evan Boone, LPC
• Gina Borrelli

• Podiatrist in Rocky Mount, VA
• Providers in Rocky Mount, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.