NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

  • Plastic Surgery Physician
  • Johnson City, TN
National Provider Identifier
1801549522
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Practice address
410 N State of Franklin Rd
Johnson City, TN 37604-6971
Phone
(423) 431-2477
Fax
(423) 431-2478
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Patricia Tarte
Title
Enrollment Team Lead
Phone
(423) 302-6567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

410 N State of Franklin Rd
Johnson City, TN 37604-6971

Mailing address

509 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2579
Phone (423) 302-6565

National Provider Directory

National Provider Directory
Tax ID family
Kingsport Internal Medi70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

410 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-2477

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1801549522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042579",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046971",
            "telephone_number": "423-431-2477",
            "fax_number": "423-431-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "TARTE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ENROLLMENT TEAM LEAD",
        "authorized_official_telephone_number": "423-302-6567"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.