NPIMap

Organization Active NPI

Blue Ridge Medical Management Corporation

Doing business as Cardiology Consultants of Johnson City

  • Cardiovascular Disease Physician
  • Johnson City, TN
National Provider Identifier
1962434068
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Doing business as
Cardiology Consultants of Johnson City
Practice address
311 Princeton Rd
Suite 7
Johnson City, TN 37601-2026
Phone
(423) 282-3236
Fax
(423) 283-4746
NPI assigned
Jul 7, 2006
Last updated
Feb 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Carl S Kilgore
Title
President
Phone
(423) 915-5100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

311 Princeton Rd
Suite 7
Johnson City, TN 37601-2026

Mailing address

311 Princeton Rd
Suite 7
Johnson City, TN 37601-2026
Phone (423) 282-3236

Other names 1

  • Cardiology Consultants of Johnson City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments

Enrollment records 2

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
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

Locations

225 Midway Medical Park
Bristol, TN 37620
Phone (423) 797-4555

1505 W Elk Ave
Ste 3
Elizabethton, TN 37643
Phone (423) 547-3380

630 Oneega Ln
Erwin, TN 37650
Phone (423) 282-3236

311 Princeton Rd
#7
Johnson City, TN 37601

311 Princeton Rd
Ste 7
Johnson City, TN 37601
Phone (423) 282-3236

16000 Johnston Memorial Dr
#3
Abingdon, VA 24211

16000 Johnston Memorial Dr
#300
Abingdon, VA 24211
Phone (276) 258-3740

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1962434068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD",
            "address_2": "SUITE 7",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "423-282-3236",
            "fax_number": "423-283-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD",
            "address_2": "SUITE 7",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "423-282-3236",
            "fax_number": "423-283-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-915-5100"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiology Consultants of Johnson City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 14, 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.