NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as Ballad Health Medical Associates

  • Internal Medicine Physician
  • Johnson City, TN
National Provider Identifier
1942520267
Registry record updated May 1, 2025
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
Med Works
Practice address
200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278
Phone
(423) 915-5033
Fax
(423) 915-5179
NPI assigned
Jun 9, 2010
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Carl Steven Kilgore
Title
President Brmmc
Phone
(423) 302-3051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278

Mailing address

200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278
Phone (423) 915-5033

Other identifiers 1

IdentifierTypeStateIssuer
Q017164MedicaidTN

Other names 3

  • Ballad Health Medical Associates Doing business as
  • Med Works Doing business as
  • BHMA Occupational Medicine Johnson City Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000996 TN Part B Supplier - Clinic/Group Practice 9739099441 Receives reassigned benefits from 562 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Johnson City, TN; Kingsport, TN; Mountain City, TN; Elizabethton, TN; Erwin, TN; Greeneville, TN

National Provider Directory

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

Organizations with this tax ID in the same state 16

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

View all 16

Locations

1505 W Elk Ave
Ste 2
Elizabethton, TN 37643
Phone (423) 543-1261

410 N State of Franklin Rd
Ste 135B
Johnson City, TN 37604
Phone (423) 431-2477

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1942520267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-915-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-915-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT BRMMC",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017164",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Works",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Occupational Medicine Johnson City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 1, 2025; 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.