BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1912318635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912318635 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | MSMG HIMA UCMH |
| Practice Address |
100 Greenway Cir Erwin TN 37650-2177 |
| Practice Telephone | 4234311810 |
| Practice Fax Number | 4234311811 |
| Mailing Telephone | 4234311810 |
| Mailing Fax Number | 4234311811 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-12-03 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q006137 | 05 | |
| VA | 1912318635 | 05 |
| Other Name | Type Code |
|---|---|
| MSMG HIMA UCMH | 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 |
100 GREENWAY CIR |
| City | ERWIN |
| State | TN |
| Zip Code | 37650-2177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790763357 | Mary Lyon Weisfeld | Nurse Anesthetist, Certified Registered | 100 Greenway Cir, Erwin, TN 37650-2177 | 2006-01-04 |
| 1477037497 | Christian Care Center of Unicoi County LLC | Skilled Nursing Facility | 100 Greenway Cir, Erwin, TN 37650-2177 | 2018-09-17 |
| 1023425428 | Valley Ridge Emergency Physicians, LLP | Emergency Medicine | 100 Greenway Cir, Erwin, TN 37650-2177 | 2014-07-17 |
| 1730518275 | Mountain States Health Alliance | Home Health | 100 Greenway Cir, Erwin, TN 37650-2177 | 2013-11-05 |
| 1922437466 | Mountain States Health Alliance | Nursing Facility/Intermediate Care Facility | 100 Greenway Cir, Erwin, TN 37650-2177 | 2013-11-05 |
| 1932451291 | Appalachian Emergency Physicians | Emergency Medicine | 100 Greenway Cir, Erwin, TN 37650-2177 | 2012-10-11 |
| 1003144494 | Unicoi County Memorial Hospital | General Acute Care Hospital | 100 Greenway Cir, Erwin, TN 37650-2177 | 2009-11-24 |
| 1396912838 | Unicoi County Outpatient Rehab | General Acute Care Hospital | 100 Greenway Cir, Erwin, TN 37650-2177 | 2008-05-14 |
| 1063620201 | Barbara Ellen Lester | Registered Nurse | 100 Greenway Cir, Erwin, TN 37650-2177 | 2007-05-20 |
| 1689893620 | Pioneer Medical Associates, PC | Hospitalist | 100 Greenway Cir, Erwin, TN 37650-2177 | 2007-04-25 |
| Find all providers in the same location | ||||
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376559070 | Gordon Wyche Moughon | Internal Medicine | 630 Oneega Avenue, Suite B, Erwin, TN 37650 | 2006-08-01 |
| 1366492639 | Charles G Miller II | Internal Medicine | 500 Love St, Erwin, TN 37650-1734 | 2006-05-10 |
| 1588140503 | Mpc | Internal Medicine | 100 Stalling Ln, Erwin, TN 37650 | 2018-07-12 |
| 1245745587 | Cumberland County Hospital System Inc | Internal Medicine | 518 E H St, Erwin, NC 28339-2209 | 2017-12-08 |
| 1568705457 | Blue Ridge Medical Management Corporation | Internal Medicine | 630 Oneega Ln, Suite A, Erwin, TN 37650-2197 | 2013-03-29 |
| 1821329665 | Md Abu Zahed Karim | Internal Medicine | 901 Denim Dr, Erwin, NC 28339 | 2010-01-19 |
| 1225152911 | Carra Avery Mclamb | Internal Medicine | 901 Denim Dr, Erwin, NC 28339-2307 | 2007-03-19 |
| 1740334853 | Dunn-erwin Medical Center, Inc. | Internal Medicine | 518 E H St, Erwin, NC 28339-2209 | 2007-01-23 |
| 1275543209 | Cumberland Clinic, PC | Internal Medicine | 630 Oneega Ln, Suite D, Erwin, TN 37650-2197 | 2006-08-09 |
| 1619904570 | Unaka Internal Medicine, LLC | Internal Medicine | 500 Love St, Erwin, TN 37650 | 2006-06-27 |
| 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.