BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1275701559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275701559 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
71 S Flannagan Ave Lebanon VA 24266 |
| Practice Telephone | 2768838042 |
| Practice Fax Number | 2768838044 |
| Mailing Telephone | 2768838042 |
| Mailing Fax Number | 2768838044 |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2019-03-29 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MAGELLAN | 600952284 | 01 |
| VA | DEPARTMENT OF LABOR | 622377500 | 01 |
| VA | 1275701559 | 05 | |
| VA | RAILROAD MEDICARE | DF7910 | 01 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Behavioral Health EAP Lebanon | Other Name - Individual/Organization |
| BHMA Behavioral Health Inpatient RCH | Other Name - Individual/Organization |
| BHMA Behavioral Health Leb | Other Name - Individual/Organization |
| MSMG BEH HLTH LEB | 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 |
71 S FLANNAGAN AVE |
| City | LEBANON |
| State | VA |
| Zip Code | 24266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932128824 | Mary Pat Ernst | Nurse Practitioner | 71 S Flannagan Ave, Lebanon, VA 24266 | 2006-07-19 |
| 1245772664 | Mountain States Health Alliance | Clinic/Center | 71 S Flannagan Ave, Lebanon, VA 24266-3600 | 2016-11-16 |
| 1508204835 | Mary Catherine Olmsted | Psychiatry & Neurology | 71 S Flannagan Ave, Lebanon, VA 24266 | 2013-06-09 |
| 1225181217 | Edgar Michael Kahn | Psychiatry & Neurology | 71 S Flannagan Ave, Lebanon, VA 24266 | 2007-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1962051763 | Best Life Physical Therapy Inc. | Physical Therapist | 383 Technology Park Drive, Lebanon, VA 24266 | 2019-09-05 |
| 1093361024 | Alexis Rae Carson | Psychologist | 84 Dr Lorraine C. Turner Dr. Russell County Public Scho, Lebanon, VA 24266 | 2019-08-15 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1659883312 | Sara K Poole | Occupational Therapist | 408 Fields Ave., Lebanon, VA 24266 | 2017-11-02 |
| Find all providers in zip 24266 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821500604 | Susan R. Tucker, Md,p.c. | Psychiatry & Neurology | 367 Nh 120 Unit B8, Lebanon, NH 03766-1430 | 2017-11-01 |
| 1295049492 | Oleksandr Osipchuk Md Phd Psychiatric Services LLC | Psychiatry & Neurology | 1424 W Baddour Pkwy, Suite C, Lebanon, TN 37087-2685 | 2010-07-29 |
| 1700054095 | Mountain States Health Alliance | Psychiatry & Neurology | 58 Carroll Steet, Lebanon, VA 24266 | 2008-02-20 |
| 1003954397 | Beth Grier Townsend | Psychiatry & Neurology | 220 E Lehman St, Lebanon, PA 17046-3930 | 2007-02-01 |
| 1366506149 | Eric Hall Schindler | Psychiatry & Neurology | 20 W Park St Ste 214, Lebanon, NH 03766-6309 | 2006-12-19 |
| 1902974520 | Laurie Reed | Psychiatry & Neurology | 43 Eagle Rdg, Lebanon, NH 03766-1900 | 2006-12-01 |
| 1609943885 | David Vining Holbrook | Psychiatry & Neurology | 1109 Stare Hwy No 31, Apt A, Lebanon, NJ 08833 | 2006-11-30 |
| 1033287941 | Robert Joseph Wendling | Psychiatry & Neurology | 85 Mechanic Street, Suite 360, Adult & Child Services of Lebanon, Lebanon, NH 03766 | 2006-11-30 |
| 1174609119 | Michael Vincent Fanizzi | Psychiatry & Neurology | 123 Mascoma Street, Lebanon, NH 03766 | 2006-10-31 |
| 1043316441 | Philhaven | Psychiatry & Neurology | 283 S Butler Rd, Lebanon, PA 17042-8939 | 2006-09-15 |
| Find all providers in LEBANON | ||||
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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.