NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as Ballad Health Medical Associates

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1346270972
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Doing business as
Ballad Health Medical Associates
MSMG Im KPT
Practice address
1916 Brookside Dr
Kingsport, TN 37660-4602
Phone
(423) 392-6000
Fax
(423) 392-6030
NPI assigned
Jul 3, 2006
Last updated
May 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1916 Brookside Dr
Kingsport, TN 37660-4602

Mailing address

1916 Brookside Dr
Kingsport, TN 37660-4602
Phone (423) 392-6000

Other identifiers 2

IdentifierTypeStateIssuer
1346270972MedicaidVA
3709280MedicaidTN

Other names 3

  • Ballad Health Medical Associates Doing business as
  • MSMG IM KPT Doing business as
  • BHMA Internal Medicine Kingsport Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000996 TN Part B Supplier - Clinic/Group Practice 9739099441 Receives reassigned benefits from 562 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Johnson City, TN; Kingsport, TN; Mountain City, TN; Elizabethton, TN; Erwin, TN; Greeneville, TN

National Provider Directory

National Provider Directory
Tax ID family
Blue Ridge Med Manage C70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

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

View all 23

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1346270972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 BROOKSIDE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604602",
            "telephone_number": "423-392-6000",
            "fax_number": "423-392-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 BROOKSIDE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604602",
            "telephone_number": "423-392-6000",
            "fax_number": "423-392-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346270972",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3709280",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG IM KPT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Internal Medicine Kingsport",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.