NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as Ballad Health Medical Associates

  • Internal Medicine Physician
  • Marion, VA
National Provider Identifier
1942083290
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Doing business as
Ballad Health Medical Associates
Practice address
245 Medical Park Dr
Marion, VA 24354-1100
Phone
(276) 378-3106
Fax
(276) 378-3205
NPI assigned
Aug 18, 2023
Last updated
Aug 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BLUE RIDGE MEDICAL MANAGEMENT CORPOARTIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Patricia Tarte
Title
Enrollment Supervisor
Phone
(423) 302-6565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

245 Medical Park Dr
Marion, VA 24354-1100

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other names 2

  • Ballad Health Medical Associates Doing business as
  • BHMA Wound Care SCCH Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory
Tax ID family
Blue Ridge Med Manage C70 organizations share this tax ID, including this one
Part of
Blue Ridge Med Manage C

Organizations with this tax ID in the same state 12

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1942083290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MEDICAL PARK DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243541100",
            "telephone_number": "276-378-3106",
            "fax_number": "276-378-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPOARTION",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "TARTE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "423-302-6565"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Wound Care SCCH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.