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BLUE RIDGE PODIATRY ASSOCIATES NPI 1952390221


NPI Information

NPI: 1952390221
Provider Name: BLUE RIDGE PODIATRY ASSOCIATES
Classification: Podiatrist - 213E00000X
Entity Type: Organization

CLIA Number: 49D1085779

Address:
390 S MAIN ST STE 103
ROCKY MOUNT, VA
ZIP 24151
Phone: (540) 483-7933
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BLUE RIDGE PODIATRY ASSOCIATES is a podiatrist in Rocky Mount, VA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. BLUE RIDGE PODIATRY ASSOCIATES NPI is 1952390221. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

390 S MAIN ST STE 103
ROCKY MOUNT, VA
ZIP 24151-767
Phone: (540) 483-7933
Fax: (540) 463-9454

The provider's authorized official is John Larry Clements .
The authorized official title is President and has the following contact phone number (540) 885-8891.

The CLIA number assigned to this NPI record is 49D1085779 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/19/2005 and was last updated on 11/22/2010.


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
1213E00000XPodiatrist0103000371VIRGINIANo
2213E00000XPodiatrist0103300877VIRGINIANo
3213E00000XPodiatrist0103000391VIRGINIAYes

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
10518620002OTHERVIRGINIANSC LEXINGTON LOCATION
2T21453MEDICARE UPINVIRGINIA
3009301747MEDICAIDVIRGINIA
4480000126MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
5000037B36MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
60518620003MEDICARE NSCVIRGINIA
70518620001OTHERVIRGINIANSC STAUNTON LOCATION
8T21532MEDICARE UPINVIRGINIA
9009301208MEDICAIDVIRGINIA
10009301283MEDICAIDVIRGINIA
11CM9184OTHERVIRGINIARR MEDICARE GROUP
12C01936MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAGROUP MEDICARE NUMBER
13U90597MEDICARE UPINVIRGINIA
14480000127MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA

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.