BLUE RIDGE PEDIATRICS LLC (NPI# 1154450757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154450757 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE PEDIATRICS LLC |
| Practice Address |
457 B Hwy 123 Bypass Seneca SC 29678 |
| Mailing Address |
457-b Hwy 123 Bypass Seneca SC 29678-0947 |
| Practice Telephone | 8648884464 |
| Practice Fax Number | 8648884462 |
| Mailing Telephone | 8648884464 |
| Mailing Fax Number | 8648884462 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2009-06-30 |
| Authorized Official Name | DR. CAREY MOLIN GULLY (OWNER) |
| Authorized Official Telephone | 8648884464 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RURAL HEALTH CLINIC | RHC 100 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457324907 | Blue Ridge Pediatrics LLC | Pediatrics | 457-b Highway 123 Bypass, Seneca, SC 29678 | 2006-02-07 |
| 1104130376 | Blue Ridge Pediatrics LLC | Clinic/Center | 457b Highway 123, Seneca, SC 29678-0842 | 2010-07-30 |
| Street Address |
457 B HWY 123 BYPASS |
| City | SENECA |
| State | SC |
| Zip Code | 29678 |
| 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 Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1104130376 | Blue Ridge Pediatrics LLC | Clinic/Center | 457b Highway 123, Seneca, SC 29678-0842 | 2010-07-30 |
| 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 | ||||
Please comment or provide details below to improve the information on BLUE RIDGE PEDIATRICS LLC.
| 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.