BLUE RIDGE RADIOLOGY, P.C. (NPI# 1881687689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881687689 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE RADIOLOGY, P.C. |
| Practice Address |
3053 W State St Bristol TN 37620-1720 |
| Practice Telephone | 4239681144 |
| Practice Fax Number | 4239683453 |
| Mailing Telephone | 4239681144 |
| Mailing Fax Number | 4239683453 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2019-05-15 |
| Authorized Official Name | KRIS LUCAS (CREDENTIALING) |
| Authorized Official Telephone | 4235739062 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UMWA | 1521046 | 01 | |
| DOL | 373437500 | 01 | |
| VA | ANTHEM | 242032 | 01 |
| BLACK LUNG | 023464700 | 01 | |
| PGBA (RR MEDICARE) | CD5029 | 01 |
| Street Address |
3053 W STATE ST |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-1720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336397124 | Robert Daniel Thurman | Radiology | 3053 W State St, Bristol, TN 37620-1720 | 2008-09-04 |
| 1992756050 | Timothy Joseph Berrigan | Radiology | 3053 W State St, Blue Ridge Radiology, P.C., Bristol, TN 37620-1720 | 2006-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| 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 |
|---|---|---|---|---|
| 1447576905 | Jeffrey Kaye | Radiology | 985 Farmington Ave, Bristol, CT 06010-3973 | 2010-04-08 |
| 1497927313 | Elise J Connell-boudoya | Radiology | 102 Moody St, Bristol, CT 06010-4440 | 2008-04-01 |
| 1588723886 | Bristol County Open Mri Services Inc. | Radiology | 1182 Hope Street, Bristol, RI 02809 | 2006-12-06 |
| 1841377629 | Bristol County Open Mri | Radiology | 1182 Hope St, Bristol, RI 02809-1126 | 2006-11-01 |
| 1093817611 | Henry Austin Carr | Radiology | 1009 Tween Hill Forest Trl, Bristol, TN 37620-5849 | 2006-09-03 |
| 1346267127 | Carlos Manuel Badiola | Radiology | 25 Collins Road, Bristol, CT 06010 | 2006-07-16 |
| 1396706024 | Jonathan V. Mai | Radiology | 1 Medical Pk. Blvd., Bristol, TN 37620 | 2006-03-31 |
| 1831161470 | Bristol Imaging PC | Radiology | 225 Hemphill Rd Bristol Imaging PC, Bristol, NH 03222-0513 | 2006-02-07 |
| 1760468904 | Allen A. Currier Jr. | Radiology | 25 Collins Rd, Bristol, CT 06010-3893 | 2005-12-20 |
| 1568466225 | Richard Helzner | Radiology | 501 Bath Rd, Bristol, PA 19007-3101 | 2005-06-10 |
| Find all providers in BRISTOL | ||||
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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.