BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1386916310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386916310 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | REGIONAL CANCER CENTER AT SYCAMORE SHOALS HOSPITAL |
| Practice Address |
1497 W Elk Ave Suite 11a Elizabethton TN 37643-2895 |
| Practice Telephone | 4232326900 |
| Practice Fax Number | 4232326903 |
| Mailing Telephone | 4232326900 |
| Mailing Fax Number | 4232326903 |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| REGIONAL CANCER CENTER AT SYCAMORE SHOALS HOSPITAL | 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 |
1497 W ELK AVE SUITE 11A |
| City | ELIZABETHTON |
| State | TN |
| Zip Code | 37643-2895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477525699 | Buddy J Clayton | Family Medicine | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2006-02-02 |
| 1225579600 | Jessica Rachel Odell | Nurse Practitioner | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2017-03-17 |
| 1629432828 | Blue Ridge Medical Management Corporation | Family Medicine | 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643-2895 | 2016-04-13 |
| 1467833673 | Blue Ridge Medical Management Corporation | Clinic/Center | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2015-06-12 |
| 1689053753 | Blue Ridge Medical Management | Internal Medicine | 1497 W Elk Ave, Suite 20b, Elizabethton, TN 37643-2895 | 2015-05-22 |
| 1457644254 | Megan D Johnson | Family Medicine | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2011-05-26 |
| 1184926719 | Blue Ridge Medical Management C Orporation | Internal Medicine | 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643-2874 | 2010-12-02 |
| 1083846984 | Tiffany Charlotte Jenkins | Nurse Practitioner | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2009-08-11 |
| 1043370687 | Kermit L. Dugger | Nurse Practitioner | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2006-12-12 |
| 1255363347 | Elizabeth Anne Defluiter | Surgery | 1497 W Elk Ave, Suite 10, Elizabethton, TN 37643-2895 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558831115 | Blue Ridge Medical Management Corporation | Internal Medicine | 404 Bemberg Rd, Elizabethton, TN 37643 | 2018-11-27 |
| 1396269072 | Solutions Medical Centers Pllc | General Practice | Solutions Medical Centers, 851 W Elk Ave, Elizabethton, TN 37643 | 2017-08-03 |
| 1437533924 | Dr. Benjamin D. Parrish and Assoc Od. PC | Optometrist | 114 S. Sycamore St, Elizabethton, TN 37643 | 2015-07-14 |
| 1972980431 | Valerie Lynn Pierce | Nurse's Aide | 101 Crowe Rd, Elizabethton, TN 37643 | 2015-05-04 |
| 1679816730 | Jeremy Meyer | Surgery | 1497 W Elk Ave Ste 10, Elizabethton, TN 37643 | 2013-03-27 |
| 1649579087 | Melinda Lynn Jennings | Pharmacist | 507 West Elk Ave, Elizbethton, TN 37643 | 2011-03-24 |
| 1588987036 | Troy Kevin Covarrubias | Driver | 219 Coal Chute Rd, Elizabethton, TN 37643 | 2010-03-11 |
| 1649502048 | Derek Charles Rhoton | Physician Assistant | 1500 West Elk Ave, Elizabethton, TN 37643 | 2010-02-10 |
| 1144456047 | Peacock Medical Equipment and Home Health Care LLC | Home Health | 1201 Highway 19 E Bypass Suite 3, Elizabethton, TN 37643 | 2009-06-05 |
| 1235386434 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 1210 Militia Ct., Elizabethton, TN 37643 | 2008-08-19 |
| Find all providers in zip 37643 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336779974 | Verdi Oncology Tennessee, PC | Internal Medicine | 2004 Hayes St Ste 720, Nashville, TN 37203-2658 | 2020-01-23 |
| 1841844099 | Tennessee Cancer Specialists Pllc | Internal Medicine | 7650 Dannaher Dr Ste 100, Powell, TN 37849-4052 | 2019-07-26 |
| 1710406350 | Hope, Blood and Cancer Center | Internal Medicine | 110 Corporate Dr Ste 120, Johnson City, TN 37604-2008 | 2017-09-14 |
| 1407201882 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 6408 Papermill Drive, Suite 220, Knoxville, TN 37919-4858 | 2016-05-04 |
| 1790192565 | Yonette Paul | Internal Medicine | 2202 N John B Dennis Hwy Ste 100, Kingsport, TN 37660-5904 | 2014-07-14 |
| 1942572862 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 2305 Chambliss Ave, Sw, Sky Ridge Medical Center Main, Cleveland, TN 37311-3899 | 2012-02-08 |
| 1619263852 | Namratha Reddy Vontela | Internal Medicine | 200 New York Ave Ste 200, Oak Ridge, TN 37830 | 2011-06-27 |
| 1356632624 | James Michael Pauff | Internal Medicine | 4488 Carothers Pkwy Ste 200, Franklin, TN 37067-6582 | 2011-04-21 |
| 1366740425 | Richert Edgar Goyette | Internal Medicine | 1706 Alcott Manor Ln, Knoxville, TN 37922-8094 | 2011-03-14 |
| 1649406687 | H2u Wellness Centers, LLC | Internal Medicine | 3322 West End Ave, Nashville, TN 37203 | 2009-06-04 |
| Find all providers with the same taxonomy | ||||
| City | ELIZABETHTON |
| Zip Code | 37643 |
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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.