Blue Ridge Medical Mangement Corporation
Organization Active NPI Urgent Care Clinic/Center · Greeneville, TN
NPI 1700313012 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1700313012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- BLUE RIDGE MEDICAL MANGEMENT CORPORATION
- Practice address
- 1744 E Andrew Johnson Hwy
Greeneville, TN 37745-4278 - Phone
- (423) 787-7496
- Fax
- (423) 787-7498
- NPI assigned
- May 17, 2017
- Organization subpart
- No
Authorized official
- Name
- Steve Kilgore
- Title
- President
- Phone
- (423) 302-3051
Practitioners 4
-
Theodore D Fox, NP
-
Lisa Carol Kirk, CFNP
-
Selma Kominek, MD
-
Judy C Umstott, NP
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
1744 E Andrew Johnson Hwy
Greeneville, TN 37745-4278
Mailing address
1744 E Andrew Johnson Hwy
Greeneville, TN 37745-4278
Phone (423) 787-7496
Other names
- Ballad Health Medical Associates
- First Assist Urgent Care
- BHMA Urgent Care Greeneville
Other providers in Greeneville, 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
- Sylvia D. Boesch-Lewis
- Debbie Ann Bolton
- Johnathan Dallas Boone
- Courtney Larae Boren
- Kyle W Boren
All providers in Greeneville, TN · Urgent Care Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.