Provider Type Icon

BLUE RIDGE HEALTHCARE MEDICAL GROUP INC. NPI 1083854251


NPI Information

NPI: 1083854251
Provider Name: BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.

Doing Business As: BLUE RIDGE ENT & ALLERGY

Classification: Otolaryngology - 207YX0007X
Entity Type: Organization

Specialization: Plastic Surgery within the Head & Neck

CLIA Number: 34D1060092

Address:
352-B EAST PARKER ROAD
MORGANTON, NC
ZIP 28655
Phone: (828) 433-6410
Get Directions

BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. is a plastic surgery within the head and neck otolaryngology in Morganton, NC. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. NPI is 1083854251. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Blue Ridge Ent & Allergy.

The provider's business location address is:

352-B EAST PARKER ROAD
MORGANTON, NC
ZIP 28655
Phone: (828) 433-6410
Fax: (828) 438-4779

The provider's authorized official is Robert Fritts .
The authorized official title is Svp-cfo and has the following contact phone number (828) 580-5545.

The CLIA number assigned to this NPI record is 34D1060092 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2009 and was last updated on 4/27/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KA0200XAllergy & ImmunologyAllergy200301349NORTH CAROLINANo
2207YX0007XOtolaryngologyPlastic Surgery within the Head & Neck200301349NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200301349OTHERNORTH CAROLINANC LICENSE
22327875DMEDICARE PINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.