BLUE RIDGE PHYSICAL MEDICINE (NPI# 1710173679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710173679 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE PHYSICAL MEDICINE |
| Practice Address |
4582 Franklin Rd Sw Roanoke VA 24014-5144 |
| Practice Telephone | 5407728052 |
| Practice Fax Number | 5407724508 |
| Mailing Telephone | 5407728052 |
| Mailing Fax Number | 5407724508 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |
| Authorized Official Name | DR. REBECCA W TANNER (OWNER) |
| Authorized Official Telephone | 5407728052 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 6801510 | 05 |
| Street Address |
4582 FRANKLIN RD SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014-5144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548367667 | Rebecca Webb Tanner | Neuromusculoskeletal Medicine, Sports Medicine | 4582 Franklin Rd Sw, Roanoke, VA 24014-5144 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801123328 | Virginia Pain & Spine Center | Clinic/Center | 5372 Fallowater Ln, Suite A, Roanoke, VA 24018-0907 | 2009-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633963 | Life Over Pain Neuropathy Center LLC | Clinic/Center | 11039 Hull Street Rd, Midlothian, VA 23112-3254 | 2020-06-16 |
| 1679089957 | Seoul Acupuncture Clinic LLC | Clinic/Center | 13880 Braddock Rd Ste 105, Centreville, VA 20121-2460 | 2017-12-21 |
| 1598910317 | Ace Care, LLC | Clinic/Center | 900 S Washington St Ste 303, Falls Church, VA 22046-4034 | 2008-11-20 |
| 1669656971 | Painrehab | Clinic/Center | 2823 Duke St, Alexandria, VA 22314-4512 | 2007-12-21 |
| 1639236284 | The Center for Pain Management | Clinic/Center | 3315 High Street, Portsmouth, VA 23707 | 2007-01-02 |
| 1023640349 | Ultimate Clinic LLC | Clinic/Center | 1437 Sams Dr Ste 122, Chesapeake, VA 23320-4587 | 2020-02-05 |
| 1407357072 | Four Seasons Acupuncture & Wellness | Clinic/Center | 11130 Fairfax Blvd Ste 204, Fairfax, VA 22030-5035 | 2018-02-28 |
| 1588112395 | Laura Elizabeth Dorsett | Clinic/Center | 6829 Elm St Ste 300, Mc Lean, VA 22101-3845 | 2016-09-21 |
| 1518317965 | Tyson's Pain Center, P.C. | Clinic/Center | 8133 Leesburg Pike, Suite 305, Vienna, VA 22182-2751 | 2016-06-16 |
| 1679985816 | Potomac Pain and Wellness Center Inc | Clinic/Center | 7535 Little River Tpke, Suite 100c, Annandale, VA 22003-2937 | 2014-05-22 |
| Find all providers with the same taxonomy | ||||
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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.