Blue Ridge Medical Management Corporation
Organization Active NPI Internal Medicine Physician · Elizabethton, TN
NPI 1467833673 · NPPES record last updated Oct 7, 2025
Key facts
- NPI
- 1467833673
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
- Practice address
- 1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895 - Phone
- (423) 542-8929
- Fax
- (423) 542-8621
- NPI assigned
- Jun 12, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. Carl Steve Kilgore
- Title
- President
- Phone
- (423) 302-3051
Practitioners 16
-
Rebecca Ann Alexander, MSN, FNP
-
Mary Beth Foran Rolen, DNP; APRN; FNP-BC
-
Linda L. Funk, NP
-
Christopher R. Gabler, P.A.-C.
-
Jean Scott Inderfurth, CRNP
-
Priscilla A Lowe, NP
-
Reghan W Maddox, FNP
-
Madison Taylor Starnes, APRN, FNP-BC
-
Brenda Jessee, FNP
-
Teanna J Moore, D.O.
-
Marivi A Niebauer, M.D.
-
Kelsie Strong, NP
-
Cristina Boston Summers, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895
Mailing address
1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895
Phone (423) 542-8929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q013904 | Medicaid | TN |
Other names
- Ballad Health Medical Associates
- BHMA Urgent Care Elizabethton
- BHMA Urgent Care Virtual Health
Other providers in Elizabethton, TN
- 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
- Blue Ridge Medical Management Corporation
All providers in Elizabethton, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.