MEDICARE: BLUE RIBBON MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1376474858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE RIBBON MEDICAL

Provider Business Mailing Address
First Line	:	4336 SEASCAPE LN
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37128-2507
Country	:	US
Telephone Number	:	931-685-4060
Fax Number	:	931-685-4062

Provider Business Practice Location Address
First Line	:	116 FRANK MARTIN RD
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7192
Country	:	US
Telephone Number	:	931-685-4060
Fax Number	:	931-685-4062

Authorized Official
Title or Position	:	MEMBER/OWNER
Name	:	WARREN J STOFFEY
Credential	:	PA-C
Telephone Number	:	615-828-5644

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “BLUE RIBBON MEDICAL ” Practice Location

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