BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1730542473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730542473 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
3175 Linden Dr Ste 3 Bristol VA 24202-5849 |
| Practice Telephone | 2762584734 |
| Practice Fax Number | 2762584736 |
| Mailing Telephone | 2762584734 |
| Mailing Fax Number | 2762584736 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2019-03-29 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS1201X |
Family Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | DEPARTMENT OF LABOR | 622863200 | 01 |
| VA | 1730542473 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Sleep Medicine Bristol | Other Name - Individual/Organization |
| MSMG Sleep Diagnostics Bristol | 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 |
3175 LINDEN DR STE 3 |
| City | BRISTOL |
| State | VA |
| Zip Code | 24202-5849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568977940 | Renaissance Medical Care | Family Medicine | 284 Blevins Boulevard, Bristol, VA 24202 | 2017-12-07 |
| 1467725879 | Leighton W Wood Dds Ms P.C. | Dentist | 103 Linden Square Drive, Bristol, VA 24202 | 2012-02-15 |
| 1285828640 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 13249 Lee Highway, Bristol, VA 24202 | 2007-08-29 |
| 1154462117 | Emdee Clinica, Pllc | Clinic/Center | 23164 Kestrel Dr, Bristol, VA 24202 | 2007-02-10 |
| 1053355859 | Commonweatlh of Virginia State Board of Health | Public Health or Welfare | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-06-15 |
| 1891775193 | William Daryl Wilson | Dentist | 15068 Lee Hwy, Ste 1000 Washington Co Health Dept, Bristol, VA 24202 | 2006-01-20 |
| 1457832123 | Justin Scott Pennington | Physical Therapist | 136 Bristol East Rd, Bristol, VA 24202 | 2018-08-22 |
| 1588104335 | Timothy G. Mcgarry, Md, Pllc | Orthopaedic Surgery | 21371 Forsythe Rd, Bristol, VA 24202 | 2017-02-27 |
| 1669532560 | Washington Co Health Dept Dental Clinic | Dentist | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-12-11 |
| 1437568946 | Family Preservation Services, Inc | Community/Behavioral Health | 7741 Rich Valley Rd, Bristol, VA 24202-0439 | 2014-08-08 |
| Find all providers in zip 24202 | ||||
| Taxonomy Code | 207QS1201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sleep Medicine |
| A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, 2008, www.aasm.org [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154980415 | Stephanie Beth Kitchen | Family Medicine | 1975 Glenn Mitchell Dr Ste 202, Virginia Beach, VA 23456-0167 | 2019-06-11 |
| 1831753334 | Bao Reardon | Family Medicine | 700 Independence Cir, Virginia Beach, VA 23455-6405 | 2019-04-30 |
| 1558891101 | Katie Danielle Buckner | Family Medicine | 16000 Johnston Memorial Drive, Abingdon, VA 24211 | 2017-06-15 |
| 1811397730 | Supriya Mannepalli | Family Medicine | 935 S Main St, Farmville, VA 23901 | 2014-08-27 |
| 1184067522 | Ashtaad Dalal | Family Medicine | 500 W Annandale Rd, Falls Church, VA 22046-4205 | 2013-04-16 |
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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.