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BLUE RIDGE GYNECOLOGY PC NPI 1093811168


NPI Information

NPI: 1093811168
Provider Name: BLUE RIDGE GYNECOLOGY PC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 49D2039095

Address:
130 PEYTON ST
WINCHESTER, VA
ZIP 22601
Phone: (540) 678-1433
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BLUE RIDGE GYNECOLOGY PC is a gynecology obstetrics gynecology in Winchester, VA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee BLUE RIDGE GYNECOLOGY PC NPI is 1093811168. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

130 PEYTON ST
WINCHESTER, VA
ZIP 22601-935
Phone: (540) 678-1433
Fax: (540) 678-1719

The provider's authorized official is Karen E. Wade .
The authorized official title is Sole Owner and has the following contact phone number (540) 678-1433.

The CLIA number assigned to this NPI record is 49D2039095 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 10/12/2015.


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
1207VG0400XObstetrics & GynecologyGynecologyYes

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
1C04135MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAMEDICARE GROUP NUMBER

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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