BLUE RIDGE NEPHROLOGY P.A. NPI 1467672204

NPI Information

  • NPI: 1467672204
  • Provider Name: BLUE RIDGE NEPHROLOGY, P.A.
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • :
  • CLIA Number: 34D1048072
  • Address: 400 SHADOWLINE DR STE 203
    BOONE, NC
    ZIP 28607
  • Phone: (828) 263-8707

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NPI Details

BLUE RIDGE NEPHROLOGY, P.A. is a nephrology internal medicine in Boone, NC. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. BLUE RIDGE NEPHROLOGY, P.A. NPI is 1467672204. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

400 SHADOWLINE DR STE 203
BOONE, NC
ZIP 28607-022
Phone: (828) 263-8707
Fax: (828) 263-8710

The provider's authorized official is Jared N Keith .
The authorized official title is President and has the following contact phone number (828) 263-8707.

The CLIA number assigned to this NPI record is 34D1048072 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 4/8/2025.

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
1174400000XSpecialist28557NORTH CAROLINANo
2207RN0300XInternal MedicineNephrologyYes

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
11386962918OTHERNORTH CAROLINANEPHROLOGY
21528032687MEDICAIDNORTH CAROLINA
31083615058OTHERNEPHROLOGY
45908642MEDICAIDNORTH CAROLINA
51386962918OTHERNEPHROLOGY
61467672204OTHERNORTH CAROLINANEPHROLOGY
71386962918MEDICAIDNORTH CAROLINA
81528032687OTHERNORTH CAROLINANEPHROLOGY

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: 11/21/2025

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