BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1134400039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134400039 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
408 N State of Franklin Rd Suite 24 Johnson City TN 37604-6089 |
| Practice Telephone | 4234311810 |
| Practice Fax Number | 4234311811 |
| Mailing Telephone | 4234311810 |
| Mailing Fax Number | 4234311811 |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | CARL STEVE KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | DEPARTMENT OF LABOR | 020487800 | 01 |
| VA | 1134400039 | 05 | |
| TN | 1525808 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Gastroenterology JC | Other Name - Individual/Organization |
| MSMG GI 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 |
408 N STATE OF FRANKLIN RD SUITE 24 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710981105 | Thomas R. Borthwick | Internal Medicine | 408 N State of Franklin Rd, Suite 24, Johnson City, TN 37604-6089 | 2005-06-13 |
| 1013364785 | Jill Hughes | Nurse Practitioner | 408 N State of Franklin Rd, Suite 12, Johnson City, TN 37604-6089 | 2016-05-23 |
| 1245685858 | Blue Ridge Medical Management Corporaiton | Internal Medicine | 408 N State of Franklin Rd, Ste 12, Johnson City, TN 37604-6089 | 2016-05-02 |
| 1619349578 | Blue Ridge Medical Management Corporation | Nurse Practitioner | 408 N State of Franklin Rd, Suite 31e, Johnson City, TN 37604-6089 | 2015-10-30 |
| 1679949572 | Julie Ann Reed | Nurse Practitioner | 408 N State of Franklin Rd, Suite 24, Johnson City, TN 37604-6089 | 2015-08-13 |
| 1962883678 | Blue Ridge Medical Management Corporation | Nurse Practitioner | 408 N State of Franklin Rd, Suite 31b, Johnson City, TN 37604-6089 | 2015-06-18 |
| 1811378854 | Blue Ridge Medical Management Corporation | Pediatrics | 408 N State of Franklin Rd, Suite 31d, Johnson City, TN 37604-6089 | 2015-06-16 |
| 1134500218 | Blue Ridge Medical Management Corporation | Nurse Practitioner | 408 N State of Franklin Rd, Suite 31c, Johnson City, TN 37604-6089 | 2015-06-15 |
| 1336541259 | Brooklyn Beaupre | Nurse Practitioner | 408 N State of Franklin Rd, Suite 24, Johnson City, TN 37604-6089 | 2014-09-23 |
| 1063823185 | Alexis Hodge Duty | Nurse Practitioner | 408 N State of Franklin Rd, Suite 31b, Johnson City, TN 37604-6089 | 2014-05-12 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1679879092 | Dhara Jesangbhai Chaudhari | Internal Medicine | 310 N State of Franklin Rd Ste 202, Johnson City, TN 37604-6063 | 2011-02-02 |
| 1699867481 | Elmer Zinner | Internal Medicine | 33 Harrison St, Johnson City, NY 13790 | 2006-09-29 |
| 1073563961 | Eapen Thomas | Internal Medicine | 2 Bandera Court, Johnson City, TN 37604-1401 | 2006-05-11 |
| 1710981105 | Thomas R. Borthwick | Internal Medicine | 408 N State of Franklin Rd, Suite 24, Johnson City, TN 37604-6089 | 2005-06-13 |
| 1225219306 | Jason Dewayne Mckinney | Internal Medicine | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2007-11-17 |
| 1548360332 | Chakradhar Madhavareddigari Reddy | Internal Medicine | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2006-09-22 |
| 1578529632 | Gastrointestinal Associates of Northeast Tennessee, PC | Internal Medicine | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2006-04-25 |
| 1922002310 | Winford Richard Mcgowan Jr. | Internal Medicine | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| 1427052828 | Lawrence W. Schmidt | Internal Medicine | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| 1871597278 | David Brent Welch | Internal Medicine | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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| 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.