BLUE RIDGE MEDICAL MANAGEMENT (NPI# 1689053753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689053753 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT |
| Other Organization Name | REGIONAL CANCER CENTER AT SSH |
| Practice Address |
1497 W Elk Ave Suite 20b Elizabethton TN 37643-2895 |
| Practice Telephone | 4232326900 |
| Practice Fax Number | 4232326903 |
| Mailing Telephone | 4232326900 |
| Mailing Fax Number | 4232326903 |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-11-18 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Regional Cancer Center At SSH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598141970 | Blue Ridge Medical Management | Internal Medicine | 245 Medical Park Dr, Marion, VA 24354-1100 | 2015-08-07 |
| 1790167351 | Blue Ridge Medical Management | Surgery | 58 Carroll Street, Suite 2d, Lebanon, VA 24266 | 2015-06-19 |
| 1811380520 | Blue Ridge Medical Management | Surgery | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2015-03-05 |
| 1063819720 | Blue Ridge Medical Management | Surgery | 98 15th St Nw, Suite 201b, Norton, VA 24273-1600 | 2014-11-24 |
| 1295143378 | Blue Ridge Medical Management | Internal Medicine | 444 Clinchfield St, Unit 201b, Kingsport, TN 37660-3606 | 2014-08-01 |
| 1114340445 | Blue Ridge Medical Management | Surgery | 310 N State of Franklin Rd, Suite 101b, Johnson City, TN 37604-6008 | 2014-01-22 |
| 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 |
| New York State Corporations | BLUE RIDGE MEDICAL MANAGEMENT LLC | 2644 East 19th Street, Brooklyn, New York 11235 |
| Street Address |
1497 W ELK AVE SUITE 20B |
| City | ELIZABETHTON |
| State | TN |
| Zip Code | 37643-2895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477525699 | Buddy J Clayton | Family Medicine | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2006-02-02 |
| 1225579600 | Jessica Rachel Odell | Nurse Practitioner | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2017-03-17 |
| 1629432828 | Blue Ridge Medical Management Corporation | Family Medicine | 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643-2895 | 2016-04-13 |
| 1467833673 | Blue Ridge Medical Management Corporation | Clinic/Center | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2015-06-12 |
| 1386916310 | Blue Ridge Medical Management Corporation | Internal Medicine | 1497 W Elk Ave, Suite 11a, Elizabethton, TN 37643-2895 | 2012-02-07 |
| 1457644254 | Megan D Johnson | Family Medicine | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2011-05-26 |
| 1184926719 | Blue Ridge Medical Management C Orporation | Internal Medicine | 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643-2874 | 2010-12-02 |
| 1083846984 | Tiffany Charlotte Jenkins | Nurse Practitioner | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2895 | 2009-08-11 |
| 1043370687 | Kermit L. Dugger | Nurse Practitioner | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2006-12-12 |
| 1255363347 | Elizabeth Anne Defluiter | Surgery | 1497 W Elk Ave, Suite 10, Elizabethton, TN 37643-2895 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558831115 | Blue Ridge Medical Management Corporation | Internal Medicine | 404 Bemberg Rd, Elizabethton, TN 37643 | 2018-11-27 |
| 1396269072 | Solutions Medical Centers Pllc | General Practice | Solutions Medical Centers, 851 W Elk Ave, Elizabethton, TN 37643 | 2017-08-03 |
| 1437533924 | Dr. Benjamin D. Parrish and Assoc Od. PC | Optometrist | 114 S. Sycamore St, Elizabethton, TN 37643 | 2015-07-14 |
| 1972980431 | Valerie Lynn Pierce | Nurse's Aide | 101 Crowe Rd, Elizabethton, TN 37643 | 2015-05-04 |
| 1679816730 | Jeremy Meyer | Surgery | 1497 W Elk Ave Ste 10, Elizabethton, TN 37643 | 2013-03-27 |
| 1649579087 | Melinda Lynn Jennings | Pharmacist | 507 West Elk Ave, Elizbethton, TN 37643 | 2011-03-24 |
| 1588987036 | Troy Kevin Covarrubias | Driver | 219 Coal Chute Rd, Elizabethton, TN 37643 | 2010-03-11 |
| 1649502048 | Derek Charles Rhoton | Physician Assistant | 1500 West Elk Ave, Elizabethton, TN 37643 | 2010-02-10 |
| 1144456047 | Peacock Medical Equipment and Home Health Care LLC | Home Health | 1201 Highway 19 E Bypass Suite 3, Elizabethton, TN 37643 | 2009-06-05 |
| 1235386434 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 1210 Militia Ct., Elizabethton, TN 37643 | 2008-08-19 |
| Find all providers in zip 37643 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | ELIZABETHTON |
| Zip Code | 37643 |
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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.