Blue Ridge Medical Management

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

0101254593 Issued in VA

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT

Doing business as

MSMG Vas Surg Nor

Practice address

98 15TH St NW
Suite 201B
Norton, VA 24273-1600

Phone

(276) 439-1490

Fax

(276) 439-1495

NPI assigned

Nov 24, 2014

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

Mr. Carl Stephen Kilgore

Title

President/Ceo

Phone

(423) 915-5116

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MSMG VAS SURG NOR Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1063819720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 15TH ST NW",
            "address_2": "SUITE 201B",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731600",
            "telephone_number": "276-439-1490",
            "fax_number": "276-439-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 15TH ST NW",
            "address_2": "SUITE 201B",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731600",
            "telephone_number": "276-439-1490",
            "fax_number": "276-439-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "423-915-5116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101254593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF7910",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "622968500",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG VAS SURG NOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Reba Bevins, D.O.
• Bio-Medical Applications of Virginia, Inc. (Mountain Empire Dialysis Center)
• Zachary Neil Blackmon, DO
• Darrell Kevin Blackwell, DO
• Brandon D Blanton, CRNA
• Blue Ridge Medical Management Corporation (First Assist / Urgent Care - Norton)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Jodie Ann Bolling, FNP

• Vascular Surgery Physician in Norton, VA
• Providers in Norton, VA by specialty
• Vascular Surgery Physician in Virginia

• 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.