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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLUE RIDGE INTEGRATIVE WELLNESS LLC
NPI 1164394177
General Practice in Dryden, VA

Active since September 19, 2025
512 DRYDEN LOOP, DRYDEN, VA 24243(941) 391-7261 Get Directions Write a Review

NPPES record last updated: September 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 18, 2026, Mar 2, 2026, Sep 19, 2025 (3 updates tracked since 2025).

About Blue Ridge Integrative Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE RIDGE INTEGRATIVE WELLNESS LLC (NPI 1164394177) is a healthcare organization registered as a general practice in Dryden, Virginia and active in the NPI registry since September 2025. The organization lists Tracy Rogers, Owner, as its authorized official.

NPPES Registry Identity

NPI1164394177
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameBLUE RIDGE INTEGRATIVE WELLNESS LLC
Location Address512 DRYDEN LOOPDryden, VA 24243
Mailing Address512 Dryden LoopDryden, VA 24243-8366 · (252) 452-6075
Phone(941) 391-7261
Organization SubpartNo
Authorized OfficialTracy RogersOwner · (941) 391-7261
Enumeration DateSeptember 19, 2025
Last NPPES UpdateSeptember 18, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2026
✔ NPI 1164394177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedHome HealthTaxonomy 251E00000X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedClinic/Center · Occupational MedicineTaxonomy 261QX0100X
512 DRYDEN LOOP, Dryden, VA 24243
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blue Ridge Integrative Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Blue Ridge Integrative Wellness LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Amanda Grizzle, PMHNP
Nurse Practitioner
NPI 1467269035
512 DRYDEN LOOP
Dryden, VA 24243
(276) 212-4325
✔ PECOSSame address
Lisa Muncy, APRN
Nurse Practitioner
NPI 1063890085
536 E MAIN ST
Appalachia, VA 24216
(276) 565-2760
✔ PECOS13 mi
Patrick Hickey, ARNP
Nurse Practitioner
NPI 1699746099
1215 CORPORATE CIR SW
Roanoke, VA 24018
(540) 404-2008
✔ PECOS✔ Accepts Medicare157 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Integrative Wellness LLC's NPI number?

The NPI number for Blue Ridge Integrative Wellness LLC is 1164394177. It was assigned to this organization in the NPPES registry on September 19, 2025.

Where is Blue Ridge Integrative Wellness LLC located?

Blue Ridge Integrative Wellness LLC is located at 512 Dryden Loop, Dryden, VA 24243. The listed phone number is (941) 391-7261.

What is Blue Ridge Integrative Wellness LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Blue Ridge Integrative Wellness LLC enrolled in Medicare?

Yes. Blue Ridge Integrative Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Ridge Integrative Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Blue Ridge Integrative Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Blue Ridge Integrative Wellness LLC was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.