Blue Ridge Medical Management Corporation

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Practice address

438 E Vann Rd
Suite 200
Greeneville, TN 37743-7202

Phone

(423) 278-1704

Fax

(423) 278-1806

NPI assigned

Aug 31, 2006

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) 915-5116

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MSMG NEUROSURG GR Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charisma Bailey, FNP-BC

  • Nurse Practitioner
  • Johnson City, TN
  • NPI 1801200506
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1215048368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3700",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023700",
            "telephone_number": "866-397-1439",
            "fax_number": "423-262-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 E VANN RD",
            "address_2": "SUITE 200",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377437202",
            "telephone_number": "423-278-1704",
            "fax_number": "423-278-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-10-29",
        "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": "423-915-5116"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3719387",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG NEUROSURG GR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol C Black, SPECIALIST
• Allie Blackwell, RN, FNP-BC
• BLC Wellington - Greeneville TN, LLC
• Blue Ridge Family Medical Practice
• Blue Ridge Medical Management C Orporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation

• All providers in Greeneville, TN
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.