Blue Ridge Medical Management Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

MSMG Gen Surg MTN

Practice address

1901 S Shady St
Mountain City, TN 37683-2021

Phone

(423) 727-1139

Fax

(423) 727-1173

NPI assigned

Jan 26, 2012

Last updated

Feb 14, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Steven Kilgore

Title

Ceo

Phone

(423) 915-5116

Specialties & licenses 1

Addresses

Other names 1

• MSMG GEN SURG MTN Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1063783751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1139",
            "fax_number": "423-727-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1139",
            "fax_number": "423-727-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-915-5116"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG GEN SURG MTN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin H. Barkley DDS Mountain City Dental
• Bio-Medical Applications of Tennessee, Inc. (FMC Dialysis Services Mountain City)
• Caleigh Blair, NP
• Reshana D Blevins, RN
• Blue Ridge Medical Management Corpoartion (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (MSMG Ortho MTN)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Senior Living
• Sara Boles, PHARMD

• Surgery Physician in Mountain City, TN
• Providers in Mountain City, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.