BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1437462025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437462025 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | MSMG GEN SURG LEB |
| Practice Address |
58 Carroll Street Ste 2 Lebanon VA 24266-0000 |
| Mailing Address |
Po Box 3700 Johnson City TN 37602-3700 |
| Practice Telephone | 2768838085 |
| Practice Fax Number | 2768838090 |
| Mailing Telephone | 8663971439 |
| Mailing Fax Number | 4232621373 |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2010-10-29 |
| Authorized Official Name | MR. CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1437462025 | 05 |
| Other Name | Type Code |
|---|---|
| MSMG GEN SURG 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 |
58 CARROLL STREET STE 2 |
| City | LEBANON |
| State | VA |
| Zip Code | 24266-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003730 | Russell County Medical Center, Inc | General Acute Care Hospital | 58 Carroll Street, Lebanon, VA 24266 | 2005-06-17 |
| 1104321405 | Amanda Elizabeth Loughlin | Nurse Practitioner | 58 Carroll Street, Lebanon, VA 24266 | 2018-03-28 |
| 1659897569 | Ashley Jane Jenkins | Nurse Practitioner | 58 Carroll Street, Suite 4, Lebanon, VA 24266 | 2017-08-22 |
| 1689043952 | Kelsey Wise Mccoy | Physician Assistant | 58 Carroll Street, Lebanon, VA 24266 | 2015-09-17 |
| 1790167351 | Blue Ridge Medical Management | Surgery | 58 Carroll Street, Suite 2d, Lebanon, VA 24266 | 2015-06-19 |
| 1407282098 | Meeradevi Sudarsanan | Nurse Practitioner | 58 Carroll Street, Suite 2, Lebanon, VA 24266 | 2013-09-16 |
| 1750690087 | Appalachian Emergency Physicians | Emergency Medicine | 58 Carroll Street, Lebanon, VA 24266-0001 | 2010-10-05 |
| 1073782900 | Mountain States Health Alliance | Anesthesiology | 58 Carroll Street, Lebanon, VA 24266-4510 | 2008-02-25 |
| 1972771236 | Mountain States Health Alliance | Anesthesiology | 58 Carroll Street, Lebanon, VA 24266 | 2008-02-20 |
| 1871761726 | Mountain States Health Alliance | Emergency Medicine | 58 Carroll Street, Lebanon, VA 24266-4510 | 2008-02-13 |
| Find all providers in the same location | ||||
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720216898 | Kyle Ward | Surgery | 120 Hospital Dr Ste 200, Lebanon, MO 65536-9227 | 2009-06-29 |
| 1699943951 | Blue Ridge Medical Mangement Corporation | Surgery | 81 Carroll Street, Lebanon, VA 24266 | 2008-02-20 |
| 1386866853 | Raman Kumar | Surgery | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2007-05-03 |
| 1194733832 | Lebanon Surgical Associates | Surgery | Carroll & Tate Sts., Suite 4, Lebanon, VA 24266 | 2006-08-04 |
| 1922028711 | Terry Wayne Shortridge | Surgery | 55 Twin Oaks, Suite C-1, Lebanon, OR 97355-2864 | 2006-07-21 |
| 1164451621 | Jimmy R Maneksha | Surgery | 125 Mascoma Street, Alice Peck Day Memorial Hospital, Lebanon, NH 03766 | 2006-06-30 |
| 1255383766 | Larimore C Warren | Surgery | 1405 W Baddour Pkwy, Suite 100, Lebanon, TN 37087-2567 | 2006-05-16 |
| 1174571863 | Barbara A. Klatchko, M.d., Ltd. | Surgery | 402 S 12th St, Lebanon, PA 17042-6617 | 2006-05-04 |
| 1215991443 | Kevin D Slentz | Surgery | 429 W Walnut St, Lebanon, KY 40033-1346 | 2006-04-14 |
| 1386612943 | Donald Duane Coker | Surgery | 229 South Fourth Street, Lebanon, PA 17042-1281 | 2006-03-09 |
| 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.