BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1568705457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568705457 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | MSMG FP IM ERW |
| Practice Address |
630 Oneega Ln Suite A Erwin TN 37650-2197 |
| Practice Telephone | 4237355700 |
| Practice Fax Number | 4237350967 |
| Mailing Telephone | 4237355700 |
| Mailing Fax Number | 4237350967 |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2017-02-14 |
| Authorized Official Name | CARL S KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RR MEDICARE | CA5744 | 01 |
| VA | 1568705457 | 05 | |
| SD | DEPARTMENT OF LABOR | 614862405 | 01 |
| TN | Q002802 | 05 |
| Other Name | Type Code |
|---|---|
| MSMG FP IM ERW | 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 |
630 ONEEGA LN SUITE A |
| City | ERWIN |
| State | TN |
| Zip Code | 37650-2197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146547 | Joseph Edward Bieberly | Family Medicine | 630 Oneega Ln, Ste A, Erwin, TN 37650-2199 | 2005-07-01 |
| 1013391507 | Mountain States Health Alliance | General Acute Care Hospital | 630 Oneega Ln, Suite E, Erwin, TN 37650-2197 | 2015-07-14 |
| 1811380520 | Blue Ridge Medical Management | Surgery | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2015-03-05 |
| 1164714234 | Unicoi County Medical Services, Inc. | Family Medicine | 630 Oneega Ln, Suite A, Erwin, TN 37650-2197 | 2011-05-09 |
| 1992004824 | Aimee Elliott | Nurse Practitioner | 630 Oneega Ln, Suite A, Erwin, TN 37650-2197 | 2011-03-17 |
| 1831212448 | Blue Ridge Medical Management Corporation | Internal Medicine | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2007-04-09 |
| 1275543209 | Cumberland Clinic, PC | Internal Medicine | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725706 | Edwards Premier Healthcare LLC | Family Medicine | 1201 North Main Avenue, Erwin, TN 37650 | 2019-11-25 |
| 1235792953 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 110 N. Industrial Drive, Erwin, TN 37650 | 2019-04-18 |
| 1114111622 | Tara Beth Coumoundouros | Pharmacist | 1252 N Main St, Erwin, TN 37650 | 2007-08-29 |
| 1679695779 | David Joe Walters | Chiropractor | 226 Love Street, Erwin, TN 37650 | 2007-04-06 |
| 1437218385 | Deandria Marie Bogart | Registered Nurse | 101okolona Drive, Erwin, TN 37650 | 2006-12-06 |
| 1881768281 | James Alexander Bowden | Emergency Medicine | 2030 Temple Hill Rd, Erwin, TN 37650 | 2006-11-17 |
| 1720161409 | Charlotte Freeman Shores | Case Manager/Care Coordinator | 218 N Main Street, Erwin, TN 37650 | 2006-10-24 |
| 1407940067 | Unicoi County Family Practice | Clinic/Center | 108 Gay Street, Erwin, TN 37650 | 2006-10-03 |
| 1972607653 | Celeste Carol Taylor | Counselor | 218 N Main, Erwin Mh Center, Erwin, TN 37650 | 2006-09-12 |
| 1972607679 | Rita Jean Richardson | Counselor | 218 N Main Ave, Erwin, TN 37650 | 2006-09-12 |
| Find all providers in zip 37650 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725706 | Edwards Premier Healthcare LLC | Family Medicine | 1201 North Main Avenue, Erwin, TN 37650 | 2019-11-25 |
| 1588128755 | Blue Ridge Medical Management Corporation | Family Medicine | 2030 Temple Hill Rd Ste B, Erwin, TN 37650-8721 | 2019-01-22 |
| 1609829241 | Jason A Colinger | Family Medicine | 105 Gay St, Erwin, TN 37650 | 2006-05-17 |
| 1821053307 | Family Medicine of Harnett County, Incorprated | Family Medicine | 901 Denim Dr, Erwin, NC 28339-2307 | 2006-04-19 |
| 1336146547 | Joseph Edward Bieberly | Family Medicine | 630 Oneega Ln, Ste A, Erwin, TN 37650-2199 | 2005-07-01 |
| 1093104929 | Lifelink Medical Group Pllc | Family Medicine | 901 Denim Dr, Erwin, NC 28339-2307 | 2015-01-15 |
| 1164714234 | Unicoi County Medical Services, Inc. | Family Medicine | 630 Oneega Ln, Suite A, Erwin, TN 37650-2197 | 2011-05-09 |
| 1881823136 | Robin Lee Harding | Family Medicine | 1826 N Main Ave, Erwin, TN 37650-8932 | 2009-07-08 |
| 1578710141 | Kenyon M Chavis | Family Medicine | 901 Denim Dr, Erwin, NC 28339-2307 | 2008-08-26 |
| 1972672269 | Daniel A Slonaker | Family Medicine | 1001 North Main Avenue, Erwin, TN 37650-0499 | 2006-11-08 |
| Find all providers in ERWIN | ||||
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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.