BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1144458332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144458332 |
Entity Type | Organization |
Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
Other Organization Name | MSMG CVT KPT |
Practice Address |
2205 Pavilion Dr Suite 102 Kingsport TN 37660-4641 |
Practice Telephone | 4239297393 |
Practice Fax Number | 4239291427 |
Mailing Telephone | 4239297393 |
Mailing Fax Number | 4239291427 |
Enumeration Date | 2009-06-25 |
Last Update Date | 2010-10-27 |
Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
Authorized Official Telephone | 4239155100 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TN | 1515098 | 05 |
Other Name | Type Code |
---|---|
MSMG CVT KPT | 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 |
2205 PAVILION DR SUITE 102 |
City | KINGSPORT |
State | TN |
Zip Code | 37660-4641 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861470080 | Adil Kabir Warsy | Emergency Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2006-01-06 |
1982080719 | Logan Cook | Nurse Practitioner | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2015-08-04 |
1164794525 | Blue Ridge Medical Management Corporation | Internal Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2012-02-01 |
1093087611 | Richard A Mcneilly | Internal Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660 | 2012-01-27 |
1598995789 | Blue Ridge Medical Management Corporation | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2009-07-22 |
1598885550 | Teresa June Burnette Lord | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2007-03-30 |
1821115676 | Kelly M Hare | Nurse Practitioner | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2007-03-26 |
1780780882 | Robert Hughes Mcqueen | Internal Medicine | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-09-15 |
1912910597 | Blue Ridge Medical Management Corporation | Internal Medicine | 2205 Pavilion Dr, Kingsport, TN 37660-4641 | 2006-08-14 |
1447279856 | Paul Andrew Lee | Physician Assistant | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-07-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
Find all providers in zip 37660 |
Taxonomy Code | 208G00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023358793 | David H Sewell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1723 Orchard Pl, Kingsport, TN 37660-4523 | 2013-02-18 |
1508168303 | Richard Neal Carter | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2010-11-30 |
1982633467 | Stanley A Gall Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2006-06-30 |
1710942545 | D Tyler Greenfield | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-04-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073855888 | Walter Howard Brott | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3701 Maloney Rd, Knoxville, TN 37920-2821 | 2013-03-19 |
1962769216 | Robert Edwin Ware | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3548 Captains Way, Knoxville, TN 37922-9420 | 2012-04-11 |
1720359862 | Hiroshi Toyohara | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 210 Crestridge Rd, Knoxville, TN 37919-5920 | 2012-01-20 |
1164793774 | Richard A Feit | Thoracic Surgery (Cardiothoracic Vascular Surgery) | East Tennessee State University Quillen College, Of Medicine Department of Academic Affairs, Johnson City, TN 37614-1708 | 2012-01-13 |
1376833210 | David Alan Baker | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 912 Millercrest Dr, Johnson City, TN 37604-4315 | 2011-04-12 |
1811146988 | Denis Michael Gilmore | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2400 Patterson St Ste 215, Nashville, TN 37203 | 2008-09-15 |
1811145584 | Joel Eugene Avery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15 Hidden Brook Lane, Signal Mtn, TN 37377 | 2008-09-05 |
1053578518 | Jeffrey Aaron Poynter | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 979 E 3rd St Ste C-520, Chattanooga, TN 37403 | 2008-05-21 |
1063698637 | Davis C. Drinkwater, Md, Plc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4390 Chickering Ln, Nashville, TN 37215-4920 | 2008-01-14 |
1629257043 | Fontaine S Hill Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 16 Colonel Winstead Dr, Brentwood, TN 37027-8936 | 2007-11-01 |
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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.