Blue Ridge Medical Management Corporation

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

Ballad Health Medical Associates
MSMG Gastroenterology MAR

Practice address

245 Medical Park Dr
Suite E
Marion, VA 24354-1100

Phone

(276) 258-3600

Fax

(276) 258-3605

NPI assigned

Dec 13, 2016

Last updated

Mar 28, 2019By 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

President

Phone

(423) 302-3051

Specialties & licenses 1

Addresses

Other names 3

• Ballad Health Medical Associates Doing business as
• MSMG Gastroenterology MAR Doing business as
• BHMA Gastroenterology Marion Other name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Steven Modlinger, M.D.

  • Nephrology Physician
  • Fairfax, VA
  • NPI 1053405688
  NPD
• Pushkas Gopalan, MD

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1376700930
  NPD

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1164966909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MEDICAL PARK DR",
            "address_2": "SUITE E",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243541100",
            "telephone_number": "276-258-3600",
            "fax_number": "276-258-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MEDICAL PARK DR",
            "address_2": "SUITE E",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243541100",
            "telephone_number": "276-258-3600",
            "fax_number": "276-258-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG Gastroenterology MAR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Gastroenterology Marion",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Medical Management (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corpoartion (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (MSMG Im Mar)
• Blue Ridge Medical Management Corporation (MSMG OB GYN Mar a)
• 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)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (MSMG General Surgery Marion)
• Blue Ridge Medical Management Corporation (MSMG GYN Mar)

• Gastroenterology Physician in Marion, VA
• Providers in Marion, VA by specialty
• Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.