BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1003273251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003273251 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
400 N State of Franklin Rd Room Lk015 Johnson City TN 37604 |
| Mailing Address |
400 N State of Franklin Rd Room Lk015 Johnson City TN 37604-6035 |
| Practice Telephone | 4234315965 |
| Practice Fax Number | 4234313572 |
| Mailing Telephone | 4234315965 |
| Mailing Fax Number | 4234313572 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT/CEO) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q019338 | 05 | |
| VA | 1003273251 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Structural Heart Clinic JC | Other Name - Individual/Organization |
| MSMG Structural Heart Clinic JC | Doing Business As Name - Organization |
| MSMG Valve Clinic JC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588128755 | Blue Ridge Medical Management Corporation | Family Medicine | 2030 Temple Hill Rd Ste B, Erwin, TN 37650-8721 | 2019-01-22 |
| 1558831115 | Blue Ridge Medical Management Corporation | Internal Medicine | 404 Bemberg Rd, Elizabethton, TN 37643 | 2018-11-27 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1255816252 | Blue Ridge Medical Management Corporation | Clinic/Center | 1901 S Shady St Ste A, Mountain City, TN 37683-2021 | 2018-09-26 |
| 1184105272 | Blue Ridge Medical Management Corporation | Ophthalmology | 410 N State of Franklin Rd Ste 130b, Johnson City, TN 37604-6972 | 2018-08-27 |
| 1841770864 | Blue Ridge Medical Management Corporation | Pediatrics | 408 N State of Franklin Rd Ste 31g, Johnson City, TN 37604-6088 | 2018-08-20 |
| 1568958775 | Blue Ridge Medical Management Corporation | Urology | 408 N State of Franklin Rd Ste 31f, Johnson City, TN 37604-6088 | 2018-07-11 |
| 1477055317 | Blue Ridge Medical Management Corporation | Urology | 16000 Johnston Memorial Dr Ste 309, Abingdon, VA 24211-7664 | 2018-03-07 |
| 1669903803 | Blue Ridge Medical Management Corporation | Internal Medicine | 1497 W Elk Ave Ste 22b, Elizabethton, TN 37643-2896 | 2017-03-21 |
| 1245771757 | Blue Ridge Medical Management Corporation | Internal Medicine | 1410 Park Ave Nw, Norton, VA 24273 | 2017-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION | 303 Med Tech Parkway, Johnson City, Tennessee 37604 |
| North Carolina Corporations | Blue Ridge Medical Management Corporation | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Street Address |
400 N STATE OF FRANKLIN RD ROOM LK015 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750389540 | Ian A Darling | Anesthesiology | 400 N State of Franklin Rd, Johnson City, TN 37604 | 2005-07-14 |
| 1174141691 | Roman Brudnik | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2020-07-10 |
| 1811510993 | Susan Cronier | Nurse Anesthetist, Certified Registered | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2020-05-22 |
| 1033731823 | Krista Michelle Bonney | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2020-05-14 |
| 1235760422 | William James Brant | Nurse Anesthetist, Certified Registered | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2020-01-28 |
| 1346881588 | Johnathan Seth Greene | Registered Nurse | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2019-09-30 |
| 1184285629 | Juliette Rita-marie Marchant | Nurse Practitioner | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-25 |
| 1629638671 | Akshit Griwan | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-20 |
| 1891355053 | Lalith Vardhan Choudhary Namburu | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-19 |
| 1932768173 | Natasha Khan | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578524930 | John F Berry | Internal Medicine | 2800 Peoples St Ste 80, Johnson City, TN 37604 | 2006-03-28 |
| 1447236849 | Christopher J Downs | Internal Medicine | 2 Professional Park Dr, Suite 15, Johnson City, TN 37604-6583 | 2005-12-16 |
| 1245228675 | Jeffrey Wayne Schoondyke | Internal Medicine | 701 N State of Franklin Rd Ste 2, Johnson City, TN 37604-3645 | 2005-10-10 |
| 1316932205 | Christopher W. Sholes | Internal Medicine | 311 Princeton Rd, Suite 7, Johnson City, TN 37601-2026 | 2005-09-16 |
| 1710988266 | Hisham Kashou | Internal Medicine | 30 Harrison St Ste 250, Johnson City, NY 13790-2176 | 2005-08-09 |
| 1134782170 | Living Water Vein Institute, P.C. | Internal Medicine | 2800 Peoples St Ste 80, Johnson City, TN 37604-4158 | 2019-04-16 |
| 1912325242 | Manar H Jbara | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2014-04-03 |
| 1790114924 | Rasha Aurshiya | Internal Medicine | 30 Harrison St Ste 250, Johnson City, NY 13790-2176 | 2013-11-07 |
| 1568760544 | Karing Hearts Cardiology, Pllc | Internal Medicine | 701 N State of Franklin Rd, Suite 2, Johnson City, TN 37604-3645 | 2011-03-01 |
| 1023252293 | Michail Vitellas | Internal Medicine | 30 Harrison St, Suite 250, Johnson City, NY 13790 | 2009-04-30 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on BLUE RIDGE MEDICAL MANAGEMENT CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.