| Blue Ridge Family Medicine | |
|
445 Gienow Rd Rural Retreat VA 24368-3210 | |
| (276) 686-4007 | |
| Not Available |
| Full Name | Blue Ridge Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 445 Gienow Rd, Rural Retreat, Virginia |
| Authorized Official Name and Position | Kiimberly Lacy (PHYSICIAN) |
| Authorized Official Contact | 2766864007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Family Medicine 306 S Main St Rural Retreat VA 24368-3269 Ph: (276) 686-4007 | Blue Ridge Family Medicine 445 Gienow Rd Rural Retreat VA 24368-3210 Ph: (276) 686-4007 |
| NPI Number | 1669178430 |
|---|---|
| Provider Enumeration Date | 02/03/2023 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 5092173203 |
|---|---|
| Medicare Enrollment ID | O20230621000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669178430 | NPI | - | NPPES |
| 30017597520001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly K Lacy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043403751 PECOS PAC ID: 2769534643 Enrollment ID: I20090723000772 |
| Provider Name | Tina M Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902374655 PECOS PAC ID: 2264778869 Enrollment ID: I20190117001948 |
| Provider Name | Laura E Skaggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861604852 PECOS PAC ID: 4183717101 Enrollment ID: I20220714000239 |
Crossroads Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7021 West Lee Highway, Rural Retreat, VA 24368 Phone: 276-686-4148 Fax: 276-686-6046 | |
Ballad Health Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7021 West Lee Highway, Suite C, Rural Retreat, VA 24368 Phone: 866-595-3662 Fax: 276-686-6046 | |
Blue Ridge Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 445 Gienow Rd, Rural Retreat, VA 24368 Phone: 276-686-4007 Fax: 276-686-4581 |