NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as MSMG General Surgery Marion

  • Surgery Physician
  • Marion, VA
National Provider Identifier
1508223116
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Doing business as
MSMG General Surgery Marion
Practice address
1616 N Main St
Suite 100 B
Marion, VA 24354-4398
Phone
(276) 783-7287
Fax
(276) 783-7786
NPI assigned
Jan 27, 2016
Last updated
Jan 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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) 915-5121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1616 N Main St
Suite 100 B
Marion, VA 24354-4398

Mailing address

509 Medtech Pkwy
Suite 100
Johnson City, TN 37604
Phone (423) 952-2122

Other names 1

  • MSMG General Surgery Marion Doing business as

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

Locations

1616 N Main St
Ste B
Marion, VA 24354
Phone (276) 783-7287

Practitioners & affiliated clinicians

Practitioners 1

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": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1508223116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MEDTECH PKWY",
            "address_2": "SUITE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-952-2122",
            "fax_number": "423-952-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N MAIN ST",
            "address_2": "SUITE 100 B",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544398",
            "telephone_number": "276-783-7287",
            "fax_number": "276-783-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-01-27",
        "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": "423-915-5121"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG General Surgery Marion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.