Blue Ridge Medical Management Corporation

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

MSMG OB GYN Rurl

Practice address

7021 W Lee Highway
Suite B
Rural Retreat, VA 24368-0000

Phone

(276) 686-3067

Fax

(276) 686-2051

NPI assigned

Jun 8, 2011

Last updated

Jun 8, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Steven Kilgore

Title

President

Phone

(423) 915-5116

Specialties & licenses 1

Addresses

Other names 1

• MSMG OB GYN RURL Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1609160571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7021 WEST LEE HIGHWAY",
            "address_2": "SUITE B",
            "city": "RURAL RETREAT",
            "state": "VA",
            "postal_code": "243680000",
            "telephone_number": "276-686-3067",
            "fax_number": "276-686-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 W LEE HIGHWAY",
            "address_2": "SUITE B",
            "city": "RURAL RETREAT",
            "state": "VA",
            "postal_code": "243680000",
            "telephone_number": "276-686-3067",
            "fax_number": "276-686-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-915-5116"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG OB GYN RURL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lily Mae Boyd, DC

• Obstetrics & Gynecology Physician in Rural Retreat, VA
• Providers in Rural Retreat, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.