NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as Ballad Health Medical Associates

  • Internal Medicine Physician
  • Elizabethton, TN
National Provider Identifier
1376846683
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 Gen Surg ELIZ
Practice address
1497 West Elk Ave
Ste 10
Elizabethton, TN 37643
Phone
(423) 542-7440
Fax
(423) 542-7445
NPI assigned
Dec 8, 2010
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 S Kilgore
Title
President
Phone
(423) 302-3051

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

1497 West Elk Ave
Ste 10
Elizabethton, TN 37643

Mailing address

1497 West Elk Ave
Ste 10
Elizabethton, TN 37643
Phone (423) 542-7440

Other names 3

  • Ballad Health Medical Associates Doing business as
  • MSMG Gen Surg ELIZ Doing business as
  • BHMA General Surgery Elizabethton 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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 4

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": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1376846683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 WEST ELK AVE",
            "address_2": "STE 10",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-542-7440",
            "fax_number": "423-542-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 WEST ELK AVE",
            "address_2": "STE 10",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-542-7440",
            "fax_number": "423-542-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "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": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG Gen Surg ELIZ",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA General Surgery Elizabethton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elizabethton, 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.