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General NPI Number Information
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NPI Number | 1447261698
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE REGIONAL HOSPITAL, INC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 800 MEDICAL CAMPUS DR
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City | BURNSVILLE
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State | NC
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Zip | 28714-9010
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Country | US
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Telephone | 828-682-0200
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Fax | 828-682-6858
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Provider Business Mailing Address
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Address Line | PO BOX 602373
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City | CHARLOTTE
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State | NC
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Zip | 28260-2373
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Country | US
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Telephone | 828-213-1500
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Fax | 828-651-6570
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | CLINT STEWART
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Credential |
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Telephone | 828-659-5196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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