BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1538315452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538315452 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | TRICITIES CANCER CARE |
| Practice Address |
2020 Brookside Drive Suite 20 Kingsport TN 37660-4633 |
| Practice Telephone | 4233924673 |
| Practice Fax Number | 4239324257 |
| Mailing Telephone | 4233924673 |
| Mailing Fax Number | 4239324257 |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2010-09-07 |
| Authorized Official Name | MR. CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1507568 | 05 | |
| VA | 1538315452 | 05 |
| Other Name | Type Code |
|---|---|
| TriCities Cancer Care | 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 |
2020 BROOKSIDE DRIVE SUITE 20 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295778538 | Centerpoint Medical Clinic LLC | Family Medicine | 2020 Brookside Drive, Suite 20, Kingsport, TN 37660 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295143378 | Blue Ridge Medical Management | Internal Medicine | 444 Clinchfield St, Unit 201b, Kingsport, TN 37660-3606 | 2014-08-01 |
| 1205016060 | Jamal Gerges Maatouk | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2007-11-09 |
| 1598885550 | Teresa June Burnette Lord | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2007-03-30 |
| 1952378747 | Malcolm Mathews IIi | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003428400 | Tennessee Oncology, Pllc | Internal Medicine | 1208 Pointe Centre Dr Ste 110, Chattanooga, TN 37421-3989 | 2020-08-18 |
| 1538324587 | Stephen Benjamin Cantrell | Internal Medicine | 2001 Mallory Ln Ste 103, Franklin, TN 37067-8234 | 2008-07-18 |
| 1487825600 | Laura Vanini Grobovsky | Internal Medicine | 1929 Lone Oak Rd, Johnson City, TN 37604-3404 | 2008-03-14 |
| 1043408578 | Mailien Reed Rogers | Internal Medicine | 111h Building 8 Dogwood Avenue, James H Quillen Va Medical Center, Johnson City, TN 37601 | 2007-10-10 |
| 1912103425 | Jill Rene Tichy | Internal Medicine | 605 Glenwood Dr Ste 200, Chattanooga, TN 37404-1130 | 2007-06-22 |
| 1518052166 | Athens Physicians Practice LLC | Internal Medicine | 705 Cook Dr Ste 201, Athens, TN 37303-3494 | 2006-10-03 |
| 1801908223 | Timothy J Panella | Internal Medicine | 1926 Alcoa Hwy Ste 410, Knoxville, TN 37920-1545 | 2006-08-31 |
| 1306869110 | Robert E. Enck | Internal Medicine | #1 Professional Park Dr., Suite 21, Regional Cancer Center, Johnson City, TN 37604 | 2006-07-25 |
| 1578597704 | Ruth E Lamar | Internal Medicine | 4488 Carothers Pkwy Ste 300, Franklin, TN 37067-6583 | 2006-07-11 |
| 1801826185 | Stuart C Spigel | Internal Medicine | 103 Natchez Park Dr, Ste 103, Dickson, TN 37055-9013 | 2006-07-03 |
| 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.