Blue Ridge Medical Management Corporation

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Practice address

444 Clinchfield St
Suite 201B
Kingsport, TN 37660-3858

Phone

(423) 302-3135

Fax

(423) 230-0224

NPI assigned

Jun 18, 2015

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 identifiers 2

Other names 3

• Ballad Health Medical Associates Doing business as
• MSMG Infectious Disease KPT Doing business as
• BHMA Infectious Disease Kingsport Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

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

• Katherine Mae Astaneh, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1902330269
  NPD
• Randy W Hoover, MD

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1255336434
  NPD
• Rebecca S Sharish, MD

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1710943329
  NPD

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1316328024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST",
            "address_2": "SUITE 201B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603858",
            "telephone_number": "423-302-3135",
            "fax_number": "423-230-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST",
            "address_2": "SUITE 201B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603858",
            "telephone_number": "423-302-3135",
            "fax_number": "423-230-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "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",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316328024",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q013946",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG Infectious Disease KPT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Infectious Disease Kingsport",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Medical Management Corp
• 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
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation

• Infectious Disease Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Infectious Disease 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.