BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1811289580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811289580 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | MSMG ENT MAR |
| Practice Address |
1205 Snider St Marion VA 24354-4221 |
| Practice Telephone | 2767832630 |
| Practice Fax Number | 2767833516 |
| Mailing Telephone | 2767832630 |
| Mailing Fax Number | 2767833516 |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-17 |
| Authorized Official Name | MR. CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MSMG ENT MAR | 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 |
1205 SNIDER ST |
| City | MARION |
| State | VA |
| Zip Code | 24354-4221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134125438 | Smyth County Community Hospital | Home Health | 1205 Snider St, Marion, VA 24354-4221 | 2005-06-22 |
| 1114219805 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 1205 Snider St, Marion, VA 24354-4221 | 2011-05-12 |
| 1396821112 | Anthony Clary | Obstetrics & Gynecology | 1205 Snider St, Marion, VA 24354-4221 | 2006-10-27 |
| 1245251099 | Smyth County Community Hospital | Otolaryngology | 1205 Snider St, Marion, VA 24354-4221 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407352461 | Heath Andrew Nier | Physical Therapist | 1141 N Main St Ste 41, Marion, VA 24354 | 2018-03-30 |
| 1255748513 | Lou Fincher | Specialist/Technologist | 601 Radio Hill Dr., Marion, VA 24354 | 2014-07-18 |
| 1467869040 | Tessa Suzanne Brown | Nurse Practitioner | 1204 N. Main Street, Marion, VA 24354 | 2014-07-16 |
| 1780927129 | Jessika Nikhole Schottelkotte | Nurse Practitioner | 245 Medical Park Dr., Marion, VA 24354 | 2013-04-04 |
| 1083893598 | Norah Ann Nutter | Nurse Practitioner | 1616 N Main St Ste 100b, Marion, VA 24354 | 2007-10-31 |
| 1962621052 | Jonathan E Rouse | Durable Medical Equipment & Medical Supplies | 242 Seven Mile Ford Rd, Marion, VA 24354 | 2007-04-25 |
| 1699831511 | Mel Leaman Free Clinic At Emory & Henry College, Inc. | Clinic/Center | 601 Radio Hill Road, Marion, VA 24354 | 2006-12-28 |
| 1568548741 | Hunter Kevin Woods | Dentist | 639 Park Boulevard, Marion, VA 24354 | 2006-10-31 |
| 1992804645 | Victoria Hollis Galloway | Physician Assistant | 601 Radio Hill Rd., Marion, VA 24354 | 2006-09-21 |
| 1154426351 | Joseph A. Beaty | Social Worker | 434 Mitchell Valley Road, Marion, VA 24354 | 2006-09-13 |
| Find all providers in zip 24354 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013967371 | Antonio E Collazo | Otolaryngology | 990 S Prospect St, Suite 1, Marion, OH 43302-6283 | 2006-05-10 |
| 1679556690 | Allied Physicians Inc., D/b/a Ear, Nose & Throat Specialists | Otolaryngology | 711 N River Dr, Marion, IN 46952-2646 | 2005-11-23 |
| 1851394522 | Michael K Delaney | Otolaryngology | 3331 W Deyoung St, Ste 208, Marion, IL 62959-5897 | 2005-05-24 |
| 1346515418 | David G Bailey Md,inc | Otolaryngology | 990 S Prospect St, Suite 1, Marion, OH 43302-6283 | 2012-03-21 |
| 1922153709 | Ent-head & Neck & Facial Surgery PC | Otolaryngology | 1391 N Baldwin Ave, Marion, IN 46952-1913 | 2007-01-24 |
| 1972602985 | David G Bailey | Otolaryngology | 990 S Prospect St, Suite 1, Marion, OH 43302-6283 | 2006-09-22 |
| 1245251099 | Smyth County Community Hospital | Otolaryngology | 1205 Snider St, Marion, VA 24354-4221 | 2006-07-21 |
| 1306897285 | Edgar Frank | Otolaryngology | 1040 Delaware Ave, Marion, OH 43302-6416 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1629459243 | Kevin James Quinn | Otolaryngology | 1200 E Broad St # 980257, Richmond, VA 23298 | 2015-06-10 |
| 1356778641 | Stat, LLC | Otolaryngology | 10812 Weather Vane Rd, Richmond, VA 23238-4161 | 2013-10-01 |
| 1134564073 | Ear, Nose, Throat & Allergy Consultants, PC | Otolaryngology | 26208 Lee Highway, Abingdon, VA 24211-7504 | 2013-05-06 |
| 1467790477 | Marco Aurelio Merida | Otolaryngology | 7216 Farm Meadow Ct, Mc Lean, VA 22101-5657 | 2013-01-25 |
| 1609142355 | Neelima Tummala | Otolaryngology | 1860 Town Center Dr Ste 420, Reston, VA 20190-5901 | 2012-03-27 |
| 1346512225 | John Laurence Manwaring | Otolaryngology | 7734 Retreat Ln, Warrenton, VA 20186-7546 | 2012-02-07 |
| 1508151887 | Jose Luis Mattos | Otolaryngology | 415 Ray C. Hunt Dr Ste 2200, Charlottesville, VA 22903-0001 | 2011-06-14 |
| 1982998852 | Blue Ridge Medical Management Corporation | Otolaryngology | 7021 W Lee Highway, Suite B, Rural Retreat, VA 24368-0000 | 2011-06-08 |
| 1609168327 | Jae Y Kim | Otolaryngology | 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 | 2011-05-12 |
| 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.