Blue Ridge Medical Management Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Practice address

1021 Coolidge St
Greeneville, TN 37743-4672

Phone

(423) 636-2339

Fax

(423) 636-2430

NPI assigned

Jul 1, 2006

Organization subpart

No

Name

C Steven Kilgore

Title

Senior Vice President

Phone

(423) 915-5185

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

• DBA Heart & Vascular Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 27, 2010.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1346279486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 COOLIDGE ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377434672",
            "telephone_number": "423-636-2339",
            "fax_number": "423-636-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 COOLIDGE ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377434672",
            "telephone_number": "423-636-2339",
            "fax_number": "423-636-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2010-05-27",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "423-915-5185"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3716298",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Heart & Vascular Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Blue Ridge Medical Mangement Corporation

• All providers in Greeneville, TN
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.