Blue Ridge Medical Management Corporation

Key facts

NPI: 1811269640
Entity type: Organization (NPI type 2)
Primary specialty: Urology Physician 208800000X
Legal business name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Practice address: 7021 West Lee Highway
Suite B
Rural Retreat, VA 24368
Phone: (276) 783-5400
Fax: (276) 783-5521
NPI assigned: Feb 9, 2012
Organization subpart: No

Authorized official

Name: Carl Steven Kilgore
Title: President
Phone: (423) 915-5116

Practitioners 3

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

Furhan Rashid Qureshi, MD Internal Medicine Physician · Sterling, VA · NPI 1306194667

NPD
Ralph Edward Fig Jr., NP Family Nurse Practitioner · Bristol, TN · NPI 1356750731

NPD FAMILY
Michael Paul Skeen, NP-C Family Nurse Practitioner · Johnson City, TN · NPI 1891122321

NPD FAMILY

Medicare participation

Medicare fee-for-service enrollment: Enrolled in VA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040715001336	VA	Part B Supplier - Clinic/Group Practice	9739099441	Receives reassigned benefits from 340 practitioners This NPI is an additional NPI on the enrollment Practice locations: Lebanon, VA; Marion, VA; Meadowview, VA; Norton, VA; Abingdon, VA; Rural Retreat, VA; Big Stone Gap, VA; Abington, VA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Urology Physician Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	208800000X			Yes
Family Nurse Practitioner Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	363LF0000X	0024166068	VA

Addresses

Primary practice location

7021 West Lee Highway
Suite B
Rural Retreat, VA 24368

Mailing address

7021 West Lee Highway
Suite B
Rural Retreat, VA 24368
Phone (276) 783-5400

Other identifiers

Identifier	Type	State	Issuer
1811269640	Medicaid	VA

Other names

MSMG URO RURL Doing business as

Other providers in Rural Retreat, VA

All providers in Rural Retreat, VA · Urology Physician in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. 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.

Verify at the official NPI Registry.