Blue Ridge Medical Management Corporation
Organization Active NPI Pulmonary Disease Physician · Elizabethton, TN
NPI 1669903803 · NPPES record last updated Aug 18, 2025
Key facts
- NPI
- 1669903803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
- Practice address
- 1497 W Elk Ave Ste 22B
Elizabethton, TN 37643-2896 - Phone
- (423) 547-5289
- Fax
- (423) 610-3430
- NPI assigned
- Mar 21, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Carl Steven Kilgore
- Title
- President/Ceo
- Phone
- (423) 302-3051
Practitioners 6
-
Cassandra Lynn Cross, PA-C
-
Jeff R Farrow, M.D.
-
Cynthia M. Hutchins, P.A.
-
Keith P Young, MD
-
Joseph Daniel Sutherland, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2328950 | Bhma Pulmonology Dba Bhma Pulmonology | Certificate of waiver | Aug 19, 2027 |
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
Locations
1497 W Elk Ave
Ste 22B
Elizabethton, TN 37643
Phone (423) 547-3380
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | |||
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
1497 W Elk Ave Ste 22B
Elizabethton, TN 37643-2896
Mailing address
1497 W Elk Ave Ste 22B
Elizabethton, TN 37643-2896
Phone (423) 547-5289
Other names
- Ballad Health Medical Associates
- MSMG Pulmonology of Elizabethton
- BHMA Pulmonology and Sleep Medicine Elizabethton
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
- Grace Reddick Gerlock Boerma
- Heather Nicole Bolton
- Ashley Danielle Bowman
All providers in Elizabethton, TN · Pulmonary Disease 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 Aug 18, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.