BLUE RIDGE MEDICAL MANAGEMENT CORPOARTION (NPI# 1417453440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417453440 |
Entity Type | Organization |
Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPOARTION |
Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
Practice Address |
701 Med Tech Pkwy Ste 300 Johnson City TN 37604-2365 |
Practice Telephone | 4232328301 |
Practice Fax Number | 4232328304 |
Mailing Telephone | 4232328301 |
Mailing Fax Number | 4232328304 |
Enumeration Date | 2018-03-30 |
Last Update Date | 2019-03-29 |
Authorized Official Name | CARL KILGORE (PRESIDENT) |
Authorized Official Telephone | 4233023051 |
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 | ||
N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TN | Q035119 | 05 |
Other Name | Type Code |
---|---|
Ballad Health Medical Associates | Doing Business As Name - Organization |
BHMA Neurosurgery, Spine and Rehabilitation Johnson City | Other Name - Individual/Organization |
BHMA Neurosurgery, Spine and Rehabilitation Kingsport | Other Name - Individual/Organization |
East Tennessee Brain And Spine Center an affiliate of MSMG | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
444 Clinchfield St Ste 103, Kingsport, TN 376603859 | 4235781518 | 4232306349 |
2 Professional Park Dr Ste 21, Johnson City, TN 376046584 | 4232328301 | 4232328304 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932617271 | Blue Ridge Medical Management Corpoartion | Orthopaedic Surgery | 410 N State of Franklin Rd Ste 130, Johnson City, TN 37604-6972 | 2018-01-22 |
1063920577 | Blue Ridge Medical Management Corpoartion | Clinic/Center | 325 Brunswick Ln, Marion, VA 24354-3903 | 2018-01-18 |
1336442649 | Blue Ridge Medical Management Corpoartion | Orthopaedic Surgery | 1497 West Elk Ave, Suite 11, Elizabethton, TN 37643 | 2010-12-08 |
1548562267 | Blue Ridge Medical Management Corpoartion | Internal Medicine | 619 W Main St, Lebanon, VA 24266-3809 | 2010-12-01 |
Street Address |
701 MED TECH PKWY STE 300 |
City | JOHNSON CITY |
State | TN |
Zip Code | 37604-2365 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962045344 | Sarah E Sumner | Physician Assistant | 701 Med Tech Pkwy Ste 300, Johnson City, TN 37604-2365 | 2019-10-18 |
1275175234 | Sara Marie Pifer | Physician Assistant | 701 Med Tech Pkwy Ste 300, Johnson City, TN 37604-2365 | 2019-10-11 |
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 | 207T00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neurological Surgery |
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922085497 | Saeed Bajwa | Neurological Surgery | 46 Harrison St, Johnson City, NY 13790 | 2005-12-27 |
1003152307 | Blue Ridge Medical Management Corporation | Neurological Surgery | 410 N State of Franklin Rd, Suite 120, Johnson City, TN 37604-6971 | 2012-12-14 |
1073870945 | Vikas Patel | Neurological Surgery | 30 Harrison St Ste 400, Johnson City, NY 13790-2176 | 2012-04-17 |
1750518544 | Selma Kominek | Neurological Surgery | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2009-06-18 |
1629088364 | Timothy Michael Fullagar | Neurological Surgery | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2006-08-08 |
1073555934 | Blue Ridge Medical Management Corporation | Neurological Surgery | 408 N State of Franklin Rd, Suite 42, Johnson City, TN 37604-6089 | 2006-06-12 |
1528009198 | Scott C Dulebohn | Neurological Surgery | 410 N State of Franklin Rd, Suite 120, Johnson City, TN 37604-6971 | 2006-06-08 |
1770549453 | Steven C Hamel | Neurological Surgery | 408 N State of Franklin Rd, Suite 42, Johnson City, TN 37604-6089 | 2006-04-22 |
1053374835 | Barry J Pollack | Neurological Surgery | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-04-11 |
1700863123 | Daniel D Galyon | Neurological Surgery | 46 Harrison St, Johnson City, NY 13790-2142 | 2005-12-28 |
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.