Blue Ridge Medical Management Corporation

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

Ballad Health Medical Associates
MSMG Cardiology KPT a

Practice address

444 Clinchfield St
Unit 201
Kingsport, TN 37660-3858

Phone

(423) 857-7650

Fax

(423) 857-7655

NPI assigned

Jun 11, 2014

Last updated

Mar 29, 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/Ceo

Phone

(423) 302-3051

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 3

• Ballad Health Medical Associates Doing business as
• MSMG CARDIOLOGY KPT A Doing business as
• BHMA Heart and Vascular Clinchfield Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 3

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.

• Sabrina D Miller, MD

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1477881100
  NPD
• Sherry E Cline, DO

  • Hospitalist Physician
  • Statesboro, GA
  • NPI 1366793861
  NPD
• Helene M. Holbrook, FNP

  • Family Nurse Practitioner
  • Hillsborough, NC
  • NPI 1972597151
  NPD

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1205249885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST",
            "address_2": "UNIT 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603858",
            "telephone_number": "423-857-7650",
            "fax_number": "423-857-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST",
            "address_2": "UNIT 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603858",
            "telephone_number": "423-857-7650",
            "fax_number": "423-857-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009978",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205249885",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG CARDIOLOGY KPT A",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Heart and Vascular Clinchfield",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Medical Management Corp (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corp
• Blue Ridge Medical Management Corporation (DBA Blue Ridge Psychiatry)
• Blue Ridge Medical Management Corporation (MSMG CVT KPT)
• 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 (Regional Cancer Center at IPMC A)
• Blue Ridge Medical Management Corporation (MSMG Peds KPT)

• Interventional Cardiology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Interventional Cardiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.