BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1598995789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598995789 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
2205 Pavilion Dr Suite 101 Kingsport TN 37660-4641 |
| Mailing Address |
2205 Pavilion Dr Ste 101 Kingsport TN 37660-4641 |
| Practice Telephone | 4238576466 |
| Practice Fax Number | 4238576456 |
| Mailing Telephone | 4238576466 |
| Mailing Fax Number | 4238576456 |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2019-03-29 |
| Authorized Official Name | STEVEN CARL KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1516429 | 05 | |
| VA | 1598995789 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Hematology and Oncology Kingsport | Other Name - Individual/Organization |
| Regional Cancer Center at Indian Path Medical Center | 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 |
2205 PAVILION DR SUITE 101 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861470080 | Adil Kabir Warsy | Emergency Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2006-01-06 |
| 1982080719 | Logan Cook | Nurse Practitioner | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2015-08-04 |
| 1164794525 | Blue Ridge Medical Management Corporation | Internal Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2012-02-01 |
| 1093087611 | Richard A Mcneilly | Internal Medicine | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660 | 2012-01-27 |
| 1144458332 | Blue Ridge Medical Management Corporation | Physician Assistant | 2205 Pavilion Dr, Suite 102, Kingsport, TN 37660-4641 | 2009-06-25 |
| 1598885550 | Teresa June Burnette Lord | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2007-03-30 |
| 1821115676 | Kelly M Hare | Nurse Practitioner | 2205 Pavilion Dr, Suite 201b, Kingsport, TN 37660-4641 | 2007-03-26 |
| 1780780882 | Robert Hughes Mcqueen | Internal Medicine | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-09-15 |
| 1912910597 | Blue Ridge Medical Management Corporation | Internal Medicine | 2205 Pavilion Dr, Kingsport, TN 37660-4641 | 2006-08-14 |
| 1447279856 | Paul Andrew Lee | Physician Assistant | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-07-18 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1790192565 | Yonette Paul | Internal Medicine | 2202 N John B Dennis Hwy Ste 100, Kingsport, TN 37660-5904 | 2014-07-14 |
| 1144297946 | Asheesh Shipstone | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2006-03-01 |
| 1750519856 | Nausheen Ahmed | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2009-06-26 |
| 1538315452 | Blue Ridge Medical Management Corporation | Internal Medicine | 2020 Brookside Drive, Suite 20, Kingsport, TN 37660-4633 | 2008-08-12 |
| 1871538389 | Ibrahim Nakhoul | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2006-06-18 |
| 1063489649 | Marco A Dasilva | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2006-03-02 |
| 1487621272 | Edwin Mcelroy Jr. | Internal Medicine | 111 W Stone Dr, Suite 300, Kingsport, TN 37660-6027 | 2006-03-01 |
| 1316919905 | Daryl Wayne Pierce | Internal Medicine | 2205 Pavilion Dr, Suite 101, Kingsport, TN 37660-4641 | 2006-02-07 |
| 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 |
| 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 |
| 1356585574 | Tennessee Cancer Specialists Pllc | Internal Medicine | 1415 Old Weisgarber Road, Suite 200, Knoxville, TN 37909 | 2009-05-01 |
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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.