BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. (NPI# 1578842035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578842035 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. |
| Other Organization Name | BLUE RIDGE RADIOLOGY |
| Practice Address |
2134 14th Avenue Cir Nw Hickory NC 28601-7357 |
| Practice Telephone | 8285801235 |
| Practice Fax Number | 8284331992 |
| Mailing Telephone | 8285801235 |
| Mailing Fax Number | 8284331992 |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2016-08-15 |
| Authorized Official Name | ROBERT G FRITTS (CFO) |
| Authorized Official Telephone | 8285805545 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 026KP | 01 |
| NC | 5920098 | 05 |
| Other Name | Type Code |
|---|---|
| Blue Ridge Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396017752 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 2293 Sugar Hill Rd, Suite B, Marion, NC 28752-7787 | 2012-02-01 |
| 1407188600 | Blue Ridge Healthcare Medical Group, Inc. | Internal Medicine | 117-b Foothills Dr, Morganton, NC 28655 | 2010-02-12 |
| 1548497209 | Blue Ridge Healthcare Medical Group, Inc. | Obstetrics & Gynecology | 20 S Medical Ct, Marion, NC 28752-4972 | 2009-06-19 |
| 1083854251 | Blue Ridge Healthcare Medical Group, Inc. | Allergy & Immunology | 352-b East Parker Road, Morganton, NC 28655 | 2009-03-02 |
| 1275725996 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 111 Foothills Dr Ste B, Morganton, NC 28655-5123 | 2007-08-16 |
| 1639244478 | Blue Ridge Healthcare Medical Group, Inc. | Radiology | 2201 S. Sterling Street, Morganton, NC 28655 | 2006-11-21 |
| 1972683126 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 2209 S. Sterling Street, Suite 300, Morganton, NC 28655 | 2006-10-16 |
| 1780772715 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 730 Malcolm Blvd., Suite 230, Rutherford College, NC 28671 | 2006-10-11 |
| 1891884748 | Blue Ridge Healthcare Medical Group, Inc. | Psychiatry & Neurology | 2201 S. Sterling St., Morganton, NC 28655 | 2006-10-11 |
| 1235227257 | Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 1901 Connelly Springs Road, Lenoir, NC 28645 | 2006-10-11 |
| Street Address |
2134 14TH AVENUE CIR NW |
| City | HICKORY |
| State | NC |
| Zip Code | 28601-7357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821034968 | Grady Shue Jr. | Radiology | 2134 14th Avenue Cir Nw, Hickory, NC 28601-7357 | 2006-06-20 |
| 1861044042 | Brandon Thomas Gregory | Physician Assistant | 2134 14th Avenue Cir Nw, Hickory, NC 28601-7357 | 2019-07-09 |
| 1568934487 | Blue Ridge Healthcare Medical Group, Inc. | Obstetrics & Gynecology | 2134 14th Avenue Cir Nw, Hickory, NC 28601-7357 | 2018-12-18 |
| 1750495073 | Nancy Jean Sciara | Nurse Practitioner | 2134 14th Avenue Cir Nw, Hickory, NC 28601-7357 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555236 | Mathew Ryan Dunn | Specialist/Technologist | 755 5th St Ne, Hickory, NC 28601 | 2020-10-14 |
| 1669086757 | Alex Neil Hines | Massage Therapist | 2759 North Center Street, Hickory, NC 28601 | 2020-09-04 |
| 1306327515 | Natasha Anderson | Nurse Practitioner | 2830 16th St Ne Apt 94, Hickory, NC 28601 | 2018-08-25 |
| 1902382120 | Danielle Marie Cisney | Counselor | 1219 10th Street Blvd Nw Apt F, Hickory, NC 28601 | 2018-07-11 |
| 1295243681 | Maggie Isabelle Mccarrick | Specialist/Technologist | 2225 6th St Nw, Hickory, NC 28601 | 2018-01-19 |
| 1487165395 | Healthstat Onsite Clinic Hsm Metal | Preventive Medicine | 180 Mcdonald Parkway Sw, Hickory, NC 28601 | 2017-10-18 |
| 1407249691 | Alexcia Dawn Pennell | Registered Nurse | 1501 Tate Blvd Sw, Suite 201, Hickory, NC 28601 | 2015-03-11 |
| 1134527484 | Pamilla Griffin Yount | Specialist | 825 3rd Ave. Nw, Hickory, NC 28601 | 2014-12-18 |
| 1831593615 | Josephine Lovelace Polhemus | Pharmacist | 12th Avenue Ne, Hickory, NC 28601 | 2014-10-22 |
| 1275957128 | Amy Lor | Acupuncturist | 46 Cloninger Mill Rd Ne Ste E, Hickory, NC 28601 | 2014-02-13 |
| Find all providers in zip 28601 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538249735 | Thomas Russell Whyte | Radiology | 830 8th Street Dr Nw, Hickory, NC 28601-3563 | 2006-10-16 |
| 1821034968 | Grady Shue Jr. | Radiology | 2134 14th Avenue Cir Nw, Hickory, NC 28601-7357 | 2006-06-20 |
| 1689611220 | Catawba Valley Medical Center | Radiology | 235 18th St Se, Hickory, NC 28602-1364 | 2006-06-01 |
| 1538428081 | Morgan C Eckerd | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2012-05-03 |
| 1427379379 | Dennis Ray Williams Jr. | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2010-06-15 |
| 1982880936 | Eric M Meredith | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2008-01-20 |
| 1306057047 | Eric Von Johnson | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2007-05-24 |
| 1184832230 | John J Battiston Jr. | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2007-05-21 |
| 1073728697 | Matthew D Dyson | Radiology | 18 13th Ave Ne, Hickory, NC 28601-3748 | 2007-05-14 |
| 1821023813 | Stephen L Farris | Radiology | 18 13th Ave Ne, Hickory, NC 28603-0308 | 2006-07-11 |
| Find all providers in HICKORY | ||||
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| 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.