Blue Ridge Medical Mangement Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BLUE RIDGE MEDICAL MANGEMENT CORPORATION

Doing business as

DBA Pinnacle Surgical Care

Practice address

81 Carroll Street
Lebanon, VA 24266

Phone

(276) 883-8085

Fax

(276) 883-8090

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

C Steven Kilgore

Title

President

Phone

(423) 915-5185

Specialties & licenses 1

Addresses

Other names 1

• DBA Pinnacle Surgical Care 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": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1699943951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3600",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242660200",
            "telephone_number": "276-883-8471",
            "fax_number": "276-883-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 CARROLL STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8085",
            "fax_number": "276-883-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-915-5185"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Pinnacle Surgical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blue Ridge Medical Management Corporation (MSMG Peds Leb)
• Blue Ridge Medical Management Corporation (MSMG Gen Surg Leb)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (MSMG Im Leb)
• Blue Ridge Medical Managment Corporation (Ballad Health Medical Associates)
• Brittany L Boardwine, LDO
• Ramona L Boyd, NP
• Lisa Marie Brooks, MS CCC SLP
• Peter J Bruzzo, DO
• Amy Amanda Bryant, DO

• Surgery Physician in Lebanon, VA
• Providers in Lebanon, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.