BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1205253770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205253770 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
800 S Mohawk Dr Suite C Erwin TN 37650-2124 |
| Practice Telephone | 4239796000 |
| Practice Fax Number | 4239796011 |
| Mailing Telephone | 4239796000 |
| Mailing Fax Number | 4239796011 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2019-03-29 |
| 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 | RAILROAD MEDICARE | CA5744 | 01 |
| VA | 1205253770 | 05 | |
| TN | Q005538 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Heart and Vascular Care Erwin | Other Name - Individual/Organization |
| MSMG CARDIOLOGY ERWIN | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2030 Temple Hill Rd Ste A, Erwin, TN 376508721 | 4237354185 | 4237354180 |
| 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 |
800 S MOHAWK DR SUITE C |
| City | ERWIN |
| State | TN |
| Zip Code | 37650-2124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932169562 | Robert W Lawson | Emergency Medicine | 800 S Mohawk Dr, Suite E, Erwin, TN 37650-2124 | 2006-03-27 |
| 1316205487 | Mark Peterson | Physical Therapist | 800 S Mohawk Dr, Suite D, Erwin, TN 37650-2124 | 2012-04-26 |
| 1487911871 | Christopher Phillips | Physical Therapist | 800 S Mohawk Dr, Suite D, Erwin, TN 37650-2124 | 2012-04-23 |
| 1902163397 | Candace Simerly | Physical Therapist | 800 S Mohawk Dr, Suite D, Erwin, TN 37650-2124 | 2012-04-23 |
| 1609158120 | Urgent Care of Erwin, LLC | Clinic/Center | 800 S Mohawk Dr, Suite E, Erwin, TN 37650-2124 | 2011-09-10 |
| 1265768188 | Associated Therapy Services of Unicoi County | Clinic/Center | 800 S Mohawk Dr, Erwin, TN 37650-2124 | 2009-10-28 |
| 1447586201 | Chad Evert Capps | Physical Therapist | 800 S Mohawk Dr, Suite D, Erwin, TN 37650-2124 | 2009-10-28 |
| 1588615496 | Furman E. Hawkins Jr. | Surgery | 800 S Mohawk Dr, Suite E, Erwin, TN 37650-2124 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725706 | Edwards Premier Healthcare LLC | Family Medicine | 1201 North Main Avenue, Erwin, TN 37650 | 2019-11-25 |
| 1235792953 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 110 N. Industrial Drive, Erwin, TN 37650 | 2019-04-18 |
| 1114111622 | Tara Beth Coumoundouros | Pharmacist | 1252 N Main St, Erwin, TN 37650 | 2007-08-29 |
| 1679695779 | David Joe Walters | Chiropractor | 226 Love Street, Erwin, TN 37650 | 2007-04-06 |
| 1437218385 | Deandria Marie Bogart | Registered Nurse | 101okolona Drive, Erwin, TN 37650 | 2006-12-06 |
| 1881768281 | James Alexander Bowden | Emergency Medicine | 2030 Temple Hill Rd, Erwin, TN 37650 | 2006-11-17 |
| 1720161409 | Charlotte Freeman Shores | Case Manager/Care Coordinator | 218 N Main Street, Erwin, TN 37650 | 2006-10-24 |
| 1407940067 | Unicoi County Family Practice | Clinic/Center | 108 Gay Street, Erwin, TN 37650 | 2006-10-03 |
| 1972607653 | Celeste Carol Taylor | Counselor | 218 N Main, Erwin Mh Center, Erwin, TN 37650 | 2006-09-12 |
| 1972607679 | Rita Jean Richardson | Counselor | 218 N Main Ave, Erwin, TN 37650 | 2006-09-12 |
| Find all providers in zip 37650 | ||||
| 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 |
|---|---|---|---|---|
| 1831212448 | Blue Ridge Medical Management Corporation | Internal Medicine | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1073085189 | Heart Center Usa Incorporated | Internal Medicine | 6500 Kirby Gate Blvd, Memphis, TN 38119-2673 | 2018-12-31 |
| 1700357035 | Morristown Heart, Pllc | Internal Medicine | Morristown Heart, Pllc, 735 Mcfarland Street, Morristown, TN 37814 | 2018-12-16 |
| 1902353444 | Hh Physician Care-elkton Tennessee | Internal Medicine | 1446 Bryson Road, Ardmore, TN 38449 | 2016-09-01 |
| 1902352750 | Rose Marie Robertson | Internal Medicine | 4003 Newman Pl, Nashville, TN 37204-4308 | 2016-08-31 |
| 1013374073 | Amg Crockett LLC | Internal Medicine | 1611 S Locust Ave, Suite 200b, Lawrenceburg, TN 38464-4055 | 2016-01-21 |
| 1821488727 | Bruce Wilson Md PC | Internal Medicine | 5885 Airline Rd, # 985, Arlington, TN 38002-5127 | 2015-01-29 |
| 1982013215 | Blue Ridge Medical Management Corporation | Internal Medicine | 1901 S Shady St Ste 1, Mountain City, TN 37683-2021 | 2014-08-12 |
| 1871835892 | Robert Maxwell Smith | Internal Medicine | 1004 Deep Woods Trl, Brentwood, TN 37027-6309 | 2013-03-18 |
| 1750630794 | David Marc Mirvis | Internal Medicine | 5676 Redding Ave, Memphis, TN 38120-1848 | 2012-09-06 |
| Find all providers with the same taxonomy | ||||
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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.