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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2328950Bhma Pulmonology Dba Bhma Pulmonology
1497 West Elk Ave, Suite 22B, Elizabethton, TN 37643
Certificate of waiverAug 19, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
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 Doing business as
  • MSMG Pulmonology of Elizabethton Doing business as
  • BHMA Pulmonology and Sleep Medicine Elizabethton Other name

Other providers in Elizabethton, TN

All providers in Elizabethton, TN · Pulmonary Disease Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.