Blue Ridge Medical Management Corporation
Organization Active NPI Cardiovascular Disease Physician · Norton, VA
NPI 1487765624 · NPPES record last updated Mar 29, 2019
Key facts
- NPI
- 1487765624
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
- Practice address
- 98 15TH St NW Ste 207
Norton, VA 24273-1600 - Phone
- (276) 439-1490
- Fax
- (276) 439-1495
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- C Steven Kilgore
- Title
- President
- Phone
- (423) 302-3051
Practitioners 2
-
Mary Mudd, FNP
-
Cheryl Ann Hess, PMHNP, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040715001336 | VA | Part B Supplier - Clinic/Group Practice | 9739099441 |
Receives reassigned benefits from 340 practitioners This NPI is an additional NPI on the enrollment Practice locations: Lebanon, VA; Marion, VA; Meadowview, VA; Norton, VA; Abingdon, VA; Rural Retreat, VA; Big Stone Gap, VA; Abington, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
98 15TH St NW Ste 207
Norton, VA 24273-1600
Mailing address
98 15TH St NW Ste 207
Norton, VA 24273-1600
Phone (276) 439-1490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020487802 | Other | VA | DEPARTMENT OF LABOR |
| 1487765624 | Medicaid | VA | |
| DF7910 | Other | VI | RAILROAD MEDICARE |
| 7100074010 | Medicaid | KY | |
| 7100133630 | Medicaid | KY |
Other names
- Ballad Health Medical Associates
- MSMG Cardiology NOR
- BHMA Heart and Vascular Care Norton
Other providers in Norton, VA
- Brandon D Blanton
- Blue Ridge Medical Management
- Blue Ridge Medical Management Corporation
- Blue Ridge Medical Management Corporation
- Blue Ridge Medical Management Corporation
- Jodie Ann Bolling
- Stanley Horton Botts Jr.
- Edward B Boyd
- Braxton F. Cann Jr MD PC
- Gregory Vaughn Brewer
All providers in Norton, VA · Cardiovascular Disease Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2019. 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.