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BLUE RIDGE WOMEN'S CENTER PA NPI 1912092867


NPI Information

NPI: 1912092867
Provider Name: BLUE RIDGE WOMEN'S CENTER, PA
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 34D0882800

Address:
150 PARKWOOD DR
ELKIN, NC
ZIP 28621
Phone: (336) 835-5945
Get Directions

BLUE RIDGE WOMEN'S CENTER, PA is an obstetrics gynecology in Elkin, NC. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. BLUE RIDGE WOMEN'S CENTER, PA NPI is 1912092867. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

150 PARKWOOD DR
ELKIN, NC
ZIP 28621-430
Phone: (336) 835-5945
Fax: (336) 835-5974

The provider's authorized official is John T Venus .
The authorized official title is President and has the following contact phone number (336) 835-5945.

The CLIA number assigned to this NPI record is 34D0882800 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 11/11/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology200400614NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12338976MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINAMEDICARE
27260595OTHERNORTH CAROLINAAETNA
389015YWMEDICAIDNORTH CAROLINA
4A9945OTHERNORTH CAROLINAMEDCOST
5015YWOTHERNORTH CAROLINABC/BS OF NC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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