BLUE RIDGE PEDIATRICS LLC


Address: 457b Highway 123, Seneca, SC 29678-0842
Phone: 8648884464

BLUE RIDGE PEDIATRICS LLC (NPI# 1104130376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104130376
Entity Type Organization
Organization Name BLUE RIDGE PEDIATRICS LLC
Practice Address 457b Highway 123
Seneca
SC 29678-0842
Practice Telephone 8648884464
Mailing Telephone 8648884464
Enumeration Date 2010-07-30
Last Update Date 2010-07-30
Authorized Official Name CAREY MOLIN GULLY (OWNER)
Authorized Official Telephone 8648884464
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
261QR1300X SC Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
SC RHC195 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1154450757 Blue Ridge Pediatrics LLC Clinic/Center 457 B Hwy 123 Bypass, Seneca, SC 29678 2007-03-02
1457324907 Blue Ridge Pediatrics LLC Pediatrics 457-b Highway 123 Bypass, Seneca, SC 29678 2006-02-07

Office Location

Street Address 457B HIGHWAY 123
City SENECA
State SC
Zip Code 29678-0842

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013185479 Natalie Brown Dixon Physician Assistant 457b Highway 123, Seneca, SC 29678-0842 2008-02-19
1881174613 Rachael Dorsey Nurse Practitioner 457b Highway 123, Seneca, SC 29678-0842 2018-08-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649803313 Synergy Spine Center, Pa Pain Medicine 457 U.S. Highway 123, Suite D, Seneca, SC 29678 2020-02-20
1437630746 Greenville Health Corporation Durable Medical Equipment & Medical Supplies 10708 Clemson Blvd, Seneca, SC 29678 2018-08-24
1497233415 Southern Telco, Inc. Emergency Response System Companies 15879 Wells Hwy, Seneca, SC 29678 2018-08-01
1598252199 Chana Ashlan Land Counselor 530 By Pass 123 Ste E2, Seneca, SC 29678 2018-04-18
1679972632 Anesthesia At Synergy Spine Nurse Anesthetist, Certified Registered 457 E Bypass 123, Seneca, SC 29678 2014-08-15
1548683303 Carolina Counseling Professionals, LLC Community/Behavioral Health 123 Loblolly Pine Dr, Seneca, SC 29678 2014-01-30
1144658170 Changing Strides Counseling, LLC Community/Behavioral Health 123 Loblolly Pine Dr., Seneca, SC 29678 2013-10-30
1417383811 Martha Williams Registered Nurse 101 Honeybee Ln, Seneca, SC 29678 2013-09-18
1073867404 The Upstate's Golden Corner of Psychiatry Psychiatry & Neurology 450 B Bypass 123, Seneca, SC 29678 2012-11-07
1043569916 Amanda Lee Simpson Pharmacist 105 Foothills Center Drive, West Union, SC 29678 2012-09-06
Find all providers in zip 29678

Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154450757 Blue Ridge Pediatrics LLC Clinic/Center 457 B Hwy 123 Bypass, Seneca, SC 29678 2007-03-02
1174161806 Prisma Health-upstate Clinic/Center 11082 N Radio Station Rd, Seneca, SC 29678-1142 2019-12-12
1700424439 Prisma Health-upstate Clinic/Center 12016 N Radio Station Rd, Seneca, SC 29678-1143 2019-12-12
1932746815 Prisma Health-upstate Clinic/Center 10110 Clemson Blvd, Seneca, SC 29678-0812 2019-12-10
1437605524 Prisma Health-upstate Clinic/Center 109 Omni Dr, Suite B, Seneca, SC 29672-9448 2016-08-29
1497147870 Greenville Health System Clinic/Center 207 Main St, Seneca, SC 29678-3245 2015-02-23
1093059214 Clemson-seneca Pediatrics Clinic/Center 207 Main Street, Seneca, SC 29678-3245 2012-11-15
1831375856 Oconee Physician Practices Clinic/Center 109 Omni Dr, Seneca, SC 29672-9448 2008-01-22
1356527352 Oconee Physician Practices Clinic/Center 106 Ram Cat Aly, Seneca, SC 29678-3244 2008-01-21
1629049127 Oconee Pediatrics Clinic/Center 15579 Wells Highway, Seneca, SC 29678-4318 2006-02-01
Find all providers in SENECA

Competitor

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City SENECA
Zip Code 29678

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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