BLUE RIDGE MEDICAL GROUP PA (NPI# 1770632077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770632077 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL GROUP PA |
| Practice Address |
3214 Charles B Root Wynd Suite 217 Raleigh NC 27612-5440 |
| Practice Telephone | 9197890909 |
| Practice Fax Number | 9197899168 |
| Mailing Telephone | 9197890909 |
| Mailing Fax Number | 9197899168 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | M.HISHAM ABDEL-AZIZ MOHAMED (PRESIDENT) |
| Authorized Official Telephone | 9197890909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
9501610 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 891116A | 05 |
| Street Address |
3214 CHARLES B ROOT WYND SUITE 217 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27612-5440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659379261 | Truecare Physical Therapy | Physical Therapist | 3214 Charles B Root Wynd, 214, Raleigh, NC 27612-5440 | 2005-07-08 |
| 1699185488 | Myeyedr Optometry of North Carolina, Pllc | Optometrist | 3214 Charles B Root Wynd, 120, Raleigh, NC 27612-5440 | 2014-05-01 |
| 1053687301 | Carolina Pelvic Health Center, Inc. | Physical Therapist | 3214 Charles B Root Wynd, Suite 101, Raleigh, NC 27612 | 2012-03-30 |
| 1730462342 | Best Care Internal Medicine and Pediatrics, Pa | Pediatrics | 3214 Charles B Root Wynd, Suite 213, Raleigh, NC 27612-5440 | 2011-09-21 |
| 1346534419 | Allmed Clinic Pa | Pediatrics | 3214 Charles B Root Wynd, Suite 213, Raleigh, NC 27612 | 2011-06-06 |
| 1023341088 | New Vision Eyecare Od Pa | Ophthalmology | 3214 Charles B Root Wynd, Suite 155, Raleigh, NC 27612-5440 | 2009-09-09 |
| 1922248822 | Carolina Staffing & Home Health Co,inc | Community/Behavioral Health | 3214 Charles B Root Wynd, Suite 101, Raleigh, NC 27612-5440 | 2009-03-05 |
| 1801019195 | Allcare Internal Medicine & Pediatrics, Pa | Internal Medicine | 3214 Charles B Root Wynd, Suite 213, Raleigh, NC 27612-5440 | 2007-04-11 |
| 1902930720 | Capital Cardiovascular Surgery Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3214 Charles B Root Wynd, 203, Raleigh, NC 27612-5440 | 2007-03-15 |
| 1174670871 | Gayatri N Dhruva | Optometrist | 3214 Charles B Root Wynd, Ste 120, Raleigh, NC 27612-5440 | 2007-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
| 1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
| 1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
| 1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
| 1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
| 1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
| 1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
| 1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| Find all providers in zip 27612 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003326802 | Essential Health & Wellness Raleigh | Clinic/Center | 2011 Falls Valley Dr Ste 111, Raleigh, NC 27615-3451 | 2017-10-05 |
| 1932571809 | Horizon Family Medicine | Clinic/Center | 308 S Blount St, Apartment 403, Raleigh, NC 27601-3102 | 2015-10-30 |
| 1093146177 | Med One | Clinic/Center | 2431 Spring Forest Rd Ste 111, Raleigh, NC 27615-7525 | 2013-11-27 |
| 1255771119 | Neighborhealth Center, Inc. | Clinic/Center | 4201 Lake Boone Trl Ste 5, Raleigh, NC 27607-7511 | 2013-06-25 |
| 1821266198 | Octavian M. Belcea, Md Pa | Clinic/Center | 2810 Wakefield Pines Dr Ste 115, Raleigh, NC 27614-7078 | 2008-02-20 |
| 1861678120 | Daniel T Sicking Md Pa | Clinic/Center | 14341 New Falls of Neuse Ste 100, Raleigh, NC 27614-8292 | 2008-01-17 |
| 1649352162 | Smartcare Operations Group, Inc. | Clinic/Center | 6140 Falls of The Neuse Road, Raleigh, NC 27609 | 2006-10-20 |
| 1871121269 | Bethany Shaffer Flinchum | Clinic/Center | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-03-31 |
| 1639617392 | Private Diagnostic Clinic | Clinic/Center | 10211 Alm St, Suite 200, Raleigh, NC 27617-8221 | 2017-02-02 |
| 1477099471 | Private Diagnositc Clinic | Clinic/Center | 10211 Alm St, Suite 200, Raleigh, NC 27617-8221 | 2017-01-13 |
| Find all providers in RALEIGH | ||||
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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.