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BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
NPI 1720318009
Urology in Connelly Springs, NC

Active since January 08, 2010CLIA 34D2003611 · Microscopy
730 MALCOLM BLVD STE 100, CONNELLY SPRINGS, NC 28612(828) 580-7962(828) 580-3392 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 13, 2025, Dec 20, 2024 (2 updates tracked since 2024).

About Blue Ridge Healthcare Medical Group, Inc. NPPES

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

BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. (NPI 1720318009), doing business as Blue Ridge Healthcare Urology, is a healthcare organization registered as an urology in Connelly Springs, North Carolina and active in the NPI registry since January 2010. The organization holds a CLIA Microscopy certificate valid through September 6, 2028 and lists Patricia Moll, Svp-cfo, as its authorized official.

NPPES Registry Identity

NPI1720318009
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameBLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Location Address730 MALCOLM BLVD STE 100Connelly Springs, NC 28612-8079
Mailing Address730 Malcolm Blvd Ste 100Connelly Springs, NC 28612-8079 · (828) 580-7962 · Fax (828) 580-3392
Phone(828) 580-7962
Fax(828) 580-3392
Organization SubpartNo
Authorized OfficialPatricia MollSvp-cfo · (828) 580-5003
Enumeration DateJanuary 8, 2010
Last NPPES UpdateFebruary 13, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2025
✔ NPI 1720318009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
730 MALCOLM BLVD STE 100, Connelly Springs, NC 28612
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Other Names 1

Doing Business AsBlue Ridge Healthcare Urology

Other Identifiers 2

Other1227YNC · Bcbs
Medicaid891227YNC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

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 Healthcare Medical Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

320

Medicare enrollment records show 320 clinicians reassign Medicare billing to Blue Ridge Healthcare Medical Group, Inc., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 104 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 30

Diagnostic Radiology84
Nurse Practitioner61
Internal Medicine40
Family Practice25
Hospitalist20
Neurology13
Obstetrics/Gynecology12
Pulmonary Disease9
22 other specialties56

Nearest to this location (20)

See all 320
Randall Bosley
Family Practice
NPI 1013650407
730 MALCOLM BLVD STE 150
Connelly Springs, NC 28612
(828) 874-4600
✔ PECOS✔ Accepts MedicareSame address
Natalie Abernathy, FNP-C
Nurse Practitioner
NPI 1477128486
730 MALCOLM BLVD # 150
Connelly Springs, NC 28612
(828) 874-4600
✔ PECOS✔ Accepts MedicareSame address
Danielle Fontaine, MD
General Surgery
NPI 1962865220
730 MALCOLM BLVD
Connelly Springs, NC 28612
(828) 580-3572
✔ PECOS✔ Accepts MedicareSame address
Amber Harding, FNP
Nurse Practitioner
NPI 1548924160
730 MALCOLM BLVD STE 150
Connelly Springs, NC 28612
(828) 874-4600
✔ PECOS✔ Accepts MedicareSame address
Shana Proffitt, ANP
Nurse Practitioner
NPI 1407109309
845 MALCOLM BLVD
Connelly Springs, NC 28612
(828) 580-3555
✔ PECOS✔ Accepts Medicare0.1 mi
Alan Jacks, M. D.
General Surgery
NPI 1992987713
845 MALCOLM BLVD.
Connelly Springs, NC 28612
(828) 580-3555
✔ PECOS✔ Accepts Medicare0.1 mi
William Evans, MD
Pain Management
NPI 1558318535
720 MALCOLM BLVD
Valdese, NC 28690
(828) 580-7620
✔ PECOS✔ Accepts Medicare0.1 mi
Sameer Baig, MD
Hematology/Oncology
NPI 1093129207
720 MALCOLM BLVD STE 200
Connelly Springs, NC 28612
(828) 580-7654
✔ PECOS✔ Accepts Medicare0.1 mi
Jessica Hildebrand, MD
Hematology/Oncology
NPI 1417248360
720 MALCOLM BLVD
Connelly Springs, NC 28612
(828) 580-7536
✔ PECOS✔ Accepts Medicare0.1 mi
Michael Kilby, FNP-BC
Nurse Practitioner
NPI 1922728773
720 MALCOLM BLVD STE 200
Connelly Springs, NC 28612
(828) 580-7654
✔ PECOS0.1 mi
Caroline Lynn, NP-C
Nurse Practitioner
NPI 1669773404
720 MALCOLM BLVD
Valdese, NC 28690
(828) 580-7536
✔ PECOS✔ Accepts Medicare0.1 mi
Michael Bauer, M.D.
Urology
NPI 1497799977
730 MALCOLM BLVD STE 100
Connelly Springs, NC 28612
(828) 580-7962
✔ PECOS✔ Accepts Medicare0.2 mi
Jackson Genant, M.D.
Family Practice
NPI 1376586909
730 MALCOLM BLVD STE 230
Connelly Springs, NC 28612
(828) 580-2811
✔ PECOS✔ Accepts Medicare0.2 mi
Quincy Greene, M.D.
General Surgery
NPI 1457492175
730 MALCOLM BLVD STE 100
Connelly Springs, NC 28612
(828) 580-2250
✔ PECOS✔ Accepts Medicare0.2 mi
Shawn Hamm, DO
Family Practice
NPI 1245725480
730 MALCOLM BLVD STE 150
Connelly Springs, NC 28612
(828) 874-4600
✔ PECOS✔ Accepts Medicare0.2 mi
Bethany Hollar, FNP-C
Nurse Practitioner
NPI 1437526175
730 MALCOLM BLVD STE 150
Connelly Springs, NC 28612
(828) 874-4600
✔ PECOS✔ Accepts Medicare0.2 mi
Shelley Mcclure, M.D.
Obstetrics/Gynecology
NPI 1316995459
110 HILLTOP ST
Connelly Springs, NC 28612
(828) 580-7432
✔ PECOS0.3 mi
Ryan Richardson, MD
Obstetrics/Gynecology
NPI 1346209293
110 HILLTOP STREET
Connelly Springs, NC 28612
(828) 580-4661
✔ PECOS✔ Accepts Medicare0.3 mi
Michelle Sreter, M.D.
Obstetrics/Gynecology
NPI 1831622497
110 HILLTOP STREET
Connelly Springs, NC 28612
(828) 580-4661
✔ PECOS✔ Accepts Medicare0.3 mi
John Sherrill, MD
Internal Medicine
NPI 1720175367
560 MALCOLM BLVD
Connelly Springs, NC 28612
(828) 874-2061
✔ PECOS✔ Accepts Medicare0.3 mi
See all 320 clinicians

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

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 for Provider-Performed Microscopy Procedures (PPMP) 34D2003611

Blue Ridge Healthcare Urology · Connelly Spg, NC
Active · expires Sep 6, 2028
CLIA Number34D2003611
Laboratory TypePhysician Office
Certificate Effective DateSeptember 7, 2026
Certificate Expiration DateSeptember 6, 2028
Laboratory DirectorMichael B. Bauer
Laboratory Phone(828) 580-7962
Laboratory LocationBlue Ridge Healthcare Urology730 Malcolm Blvd Ste 100, Connelly Spg, NC 28612
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Healthcare Medical Group, Inc.'s NPI number?

The NPI number for Blue Ridge Healthcare Medical Group, Inc. is 1720318009. It was assigned to this organization in the NPPES registry on January 8, 2010. The provider is doing business as Blue Ridge HealthCare Urology.

Where is Blue Ridge Healthcare Medical Group, Inc. located?

Blue Ridge Healthcare Medical Group, Inc. is located at 730 Malcolm Blvd Ste 100, Connelly Springs, NC 28612. The listed phone number is (828) 580-7962.

What is Blue Ridge Healthcare Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Blue Ridge Healthcare Medical Group, Inc. enrolled in Medicare?

Yes. Blue Ridge Healthcare Medical Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Ridge Healthcare Medical Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 320 clinicians in 30 Medicare specialties reassign their Medicare billing to Blue Ridge Healthcare Medical Group, Inc.. 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. The largest specialties are Diagnostic Radiology (84), Nurse Practitioner (61) and Internal Medicine (40). Of these, 4 practice at this address and 104 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Blue Ridge Healthcare Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D2003611) is associated with this NPI, valid through September 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Blue Ridge Healthcare Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Blue Ridge Healthcare Medical Group, Inc. 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 Healthcare Medical Group, Inc. was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.