Blue Ridge Medical Management Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

Ballad Health Medical Associates
MSMG Cardiology JC

Practice address

310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6008

Phone

(423) 979-6000

Fax

(423) 979-6011

NPI assigned

Jun 2, 2006

Last updated

Mar 29, 2019By 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) 302-3051

Specialties & licenses 4

Addresses

Other identifiers 5

Other names 3

• Ballad Health Medical Associates Doing business as
• MSMG CARDIOLOGY JC Doing business as
• BHMA Heart and Vascular Care Johnson City Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations (25 of 57)

Practitioners 151

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Summer Rae Culbert, DNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Nashville, TN
  • NPI 1811499205
  NPD
• William Scott Dodd, M.D.

  • Pediatrics Physician
  • Johnson City, TN
  • NPI 1134415698
  NPD
• Syed Shiraz Hyder, M.D.

  • Neurology Physician
  • Johnson City, TN
  • NPI 1245383108
  NPD
• Shari K Rajoo, MD

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1730149790
  NPD
• Melanie Leigh Wade, MSN, NP

  • Family Nurse Practitioner
  • Elizabethton, TN
  • NPI 1487089322
  NPD
• Sally Blackburn, NP

  • Family Nurse Practitioner
  • Bristol, VA
  • NPI 1700857216
  NPD
• Mohamed Y Ahmed, M.B.B.CH

  • Pediatric Pulmonology Physician
  • Johnson City, TN
  • NPI 1548624273
  NPD (past)
• Todd William Aiken, MD

  • Pediatrics Physician
  • Greeneville, TN
  • NPI 1336368919
  NPD (past)
• Muhammad Ali, MD

  • Hospitalist Physician
  • Bristol, TN
  • NPI 1265626279
  NPD (past)
• Willie Thomas Anderson III, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Johnson City, TN
  • NPI 1851448476
  NPD (past)
• Joshua L Andrews, PA

  • Medical Physician Assistant
  • Erwin, TN
  • NPI 1295498210
  NPD (past)
• Evelyn Artz

  • Pediatric Endocrinology Physician
  • Johnson City, TN
  • NPI 1508929373
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1740227131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 400",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-979-6000",
            "fax_number": "423-979-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 400",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-979-6000",
            "fax_number": "423-979-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-03-29",
        "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": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3377130",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740227131",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740227131",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5744",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "020487820",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG CARDIOLOGY JC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Heart and Vascular Care Johnson City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (First Assist Urgent Care)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medcial Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)

• Cardiovascular Disease Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.