Blue Ridge Medical Management Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing business as

MSMG Cardiology Greeneville

Practice address

1406 Tusculum Blvd
Mob 2 Suite 2001 a
Greeneville, TN 37745-4332

Phone

(423) 787-7425

Fax

(423) 797-7482

NPI assigned

Dec 26, 2012

Last updated

Jul 25, 2013By 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 / Ceo

Phone

(423) 915-5000

Specialties & licenses 1

Addresses

Other names 1

• MSMG CARDIOLOGY GREENEVILLE 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.

• Celso T Ebeo, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Johnson City, TN
  • NPI 1104812734
  NPD
• Sherry W. Love, NP

  • Family Nurse Practitioner
  • Marion, VA
  • NPI 1194104976
  NPD

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1912243718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 TUSCULUM BLVD",
            "address_2": "MOB 2 SUITE 2001 A",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454332",
            "telephone_number": "423-787-7425",
            "fax_number": "423-797-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 TUSCULUM BLVD",
            "address_2": "MOB 2 SUITE 2001 A",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454332",
            "telephone_number": "423-787-7425",
            "fax_number": "423-797-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "423-915-5000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMG CARDIOLOGY GREENEVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blue Ridge Medical Management Corporation (MSMG Neurosurg GR)
• Blue Ridge Medical Management Corporation (DBA Heart & Vascular Group)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (DBA Applalachian Neurosurgical Clinic)
• Blue Ridge Medical Mangement Corporation (Ballad Health Medical Associates)
• Sylvia D. Boesch-Lewis, FNP-BC
• Debbie Ann Bolton, APN
• Johnathan Dallas Boone, PHARMD
• Courtney Larae Boren, OTR/L

• Cardiovascular Disease Physician in Greeneville, TN
• Providers in Greeneville, 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 Jul 25, 2013; 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.