BLUE RIDGE PEDIATRICS LLC
NPI 1104130376
Clinic/Center - Rural Health in Seneca, SC
About Blue Ridge Pediatrics Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE RIDGE PEDIATRICS LLC (NPI 1104130376) is a healthcare organization registered as a rural health in Seneca, South Carolina and active in the NPI registry since July 2010. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Carey Molin Gully, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 32D0686202
Blue Ridge Pediatrics, LLC · Seneca, SCFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Ridge Pediatrics LLC's NPI number?
The NPI number for Blue Ridge Pediatrics LLC is 1104130376. It was assigned to this organization in the NPPES registry on July 30, 2010.
Where is Blue Ridge Pediatrics LLC located?
Blue Ridge Pediatrics LLC is located at 457B Highway 123, Seneca, SC 29678. The listed phone number is (864) 888-4464.
What is Blue Ridge Pediatrics LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Does Blue Ridge Pediatrics LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 32D0686202) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Blue Ridge Pediatrics LLC accept?
Health plans from Ambetter from Absolute Total Care and Ambetter of North Carolina list Blue Ridge Pediatrics LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Blue Ridge Pediatrics LLC was last updated on July 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blue Ridge Pediatrics Llc · NPI 1104130376
Rural Health organization in Seneca, South Carolina. Organization record, active in the CMS NPPES registry since July 30, 2010.
## Identity
- **NPI:** 1104130376 (Entity type: Organization)
- **Enumerated:** July 30, 2010
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Carey Gully, OWNER
## Practice location
- **Address:** 457B HIGHWAY 123, Seneca, SC 29678-0842
- **Phone:** (864) 888-4464
## Record status
- **NPPES last updated:** July 30, 2010
- **Other identifiers:** Medicaid RHC195 (SC)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1104130376) · Data from the CMS NPPES public registry.