Blue Ridge Medical Management Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

DBA Heart & Vascular Group

Practice address

630 Oneega LN
Suite D
Erwin, TN 37650-2197

Phone

(423) 743-0440

Fax

(423) 743-2828

NPI assigned

Apr 9, 2007

Last updated

Apr 1, 2009By 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) 915-5100

Specialties & licenses 1

Addresses

Other names 1

• DBA Heart & Vascular Group Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 2

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.

• Rabab Ismail Elmezayen, MD., PHD.

  • Infectious Disease Physician
  • Johnson City, TN
  • NPI 1184949489
  NPD
• Neil W Kooy, M.D.

  • Pediatric Critical Care Medicine Physician
  • Johnson City, TN
  • NPI 1689626343
  NPD

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1831212448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 ONEEGA LN",
            "address_2": "SUITE D",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502197",
            "telephone_number": "423-743-0440",
            "fax_number": "423-743-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 ONEEGA LN",
            "address_2": "SUITE D",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502197",
            "telephone_number": "423-743-0440",
            "fax_number": "423-743-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2009-04-01",
        "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": "423-915-5100"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Heart & Vascular Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation (Ballad Health)
• Blue Ridge Medical Management Corporation (MSMG FP Im Erw)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (MSMG Hima Ucmh)
• Deandria Marie Bogart, R.N.
• Francisco E Borquez, PT
• James Alexander Bowden, MD
• Bradshaw Family Medical, LLC

• Cardiovascular Disease Physician in Erwin, TN
• Providers in Erwin, 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 Apr 1, 2009; 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.