NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

  • Pediatric Cardiology Physician
  • Abingdon, VA
National Provider Identifier
1265898142
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Practice address
16000 Johnston Memorial Dr
Suite 312E
Abingdon, VA 24211-7664
Phone
(276) 258-2765
Fax
(276) 258-2766
NPI assigned
Jan 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Carl Steve Kilgore
Title
President
Phone
(423) 915-5185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

16000 Johnston Memorial Dr
Suite 312E
Abingdon, VA 24211-7664

Mailing address

16000 Johnston Memorial Dr
Suite 312E
Abingdon, VA 24211-7664
Phone (276) 258-2765

Other names 1

  • MSMG Pediatric Cardiology ABG Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kingsport Internal Medi70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

16000 Johnston Memorial Dr
Ste 312E
Abingdon, VA 24211
Phone (276) 258-2765

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1265898142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "address_2": "SUITE 312E",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-2765",
            "fax_number": "276-258-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "address_2": "SUITE 312E",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-2765",
            "fax_number": "276-258-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-915-5185"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG Pediatric Cardiology ABG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abingdon, VA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.