BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. – NPI #1740558949
Surgery

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. is a surgeon located in CONNELLY SPRINGS, NC. NPPES has assigned the NPI number 1740558949 to BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. on December 02, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 208600000X from the Health Care Provider Taxonomy code set, which is classified as Surgery.

The NPI profile was last updated on Feb 06, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. below.

NPI Profile for
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.

NPI Number
1740558949
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Other name(s)
All associated names:

Doing Business As (dba)
Alan F. Jacks, MD, PA
Primary location
845 MALCOLM BOULEVARD
CONNELLY SPRINGS, NC 28612-8615
Phone: (828) 580-3555 Fax: (828) 874-2111
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PATRICIA MOLL
SVP-CFO
Phone: (828) 580-5003
Updated
Certification Date
Feb 06, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherMEDICARE PTANNC2327875
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208600000X
- Surgery (Primary)
NC 969601640

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.1068.1
Content Type
Affiliation
Y
Endpoint Location
2720 DUNDEE RD # 302,
NORTHBROOK, IL 77025-1669