BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1093120222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093120222 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
403 N State of Franklin Rd Johnson City TN 37604-6034 |
| Practice Telephone | 4234317047 |
| Practice Fax Number | 4239790569 |
| Mailing Telephone | 4234317047 |
| Mailing Fax Number | 4239790569 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | MR. CARL S KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | Y |
| Parent Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q013746 | 05 | |
| VA | 1093120222 | 05 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Behavioral Health JC | Other Name - Individual/Organization |
| BHMA Behaviroal Health Woodridge OP JC | Other Name - Individual/Organization |
| MSMG Beh Hlth JC - OP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588128755 | Blue Ridge Medical Management Corporation | Family Medicine | 2030 Temple Hill Rd Ste B, Erwin, TN 37650-8721 | 2019-01-22 |
| 1558831115 | Blue Ridge Medical Management Corporation | Internal Medicine | 404 Bemberg Rd, Elizabethton, TN 37643 | 2018-11-27 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1255816252 | Blue Ridge Medical Management Corporation | Clinic/Center | 1901 S Shady St Ste A, Mountain City, TN 37683-2021 | 2018-09-26 |
| 1184105272 | Blue Ridge Medical Management Corporation | Ophthalmology | 410 N State of Franklin Rd Ste 130b, Johnson City, TN 37604-6972 | 2018-08-27 |
| 1841770864 | Blue Ridge Medical Management Corporation | Pediatrics | 408 N State of Franklin Rd Ste 31g, Johnson City, TN 37604-6088 | 2018-08-20 |
| 1568958775 | Blue Ridge Medical Management Corporation | Urology | 408 N State of Franklin Rd Ste 31f, Johnson City, TN 37604-6088 | 2018-07-11 |
| 1477055317 | Blue Ridge Medical Management Corporation | Urology | 16000 Johnston Memorial Dr Ste 309, Abingdon, VA 24211-7664 | 2018-03-07 |
| 1669903803 | Blue Ridge Medical Management Corporation | Internal Medicine | 1497 W Elk Ave Ste 22b, Elizabethton, TN 37643-2896 | 2017-03-21 |
| 1245771757 | Blue Ridge Medical Management Corporation | Internal Medicine | 1410 Park Ave Nw, Norton, VA 24273 | 2017-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION | 303 Med Tech Parkway, Johnson City, Tennessee 37604 |
| North Carolina Corporations | Blue Ridge Medical Management Corporation | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Street Address |
403 N STATE OF FRANKLIN RD |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013998004 | Rakeshkumar Bhagwandas Patel | Internal Medicine | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2005-11-08 |
| 1962016162 | Paul Gilley | Nurse Practitioner | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2020-09-04 |
| 1215575832 | Jeffrey Wayne Margeson | Nurse Practitioner | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2019-12-13 |
| 1942847694 | Haley Elizabeth Elliott | Registered Nurse | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2019-12-02 |
| 1770079675 | Victoria W Johnson | Physician Assistant | 403 N State of Franklin Rd, Johnson City, TN 37604 | 2018-07-03 |
| 1881124139 | Preston Fhorest Helmly | Student in an Organized Health Care Education/Training Program | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2017-06-19 |
| 1902330269 | Katherine Mae Astaneh | Nurse Practitioner | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2017-04-13 |
| 1962857862 | Stevenson Wayne Howard | Psychiatry & Neurology | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2016-04-28 |
| 1902213275 | Jasmine Michelle Love | Nurse Practitioner | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2014-07-17 |
| 1841619582 | Kathleen Ann Seaton | Psychiatry & Neurology | 403 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2014-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228619 | Whidbey Island Public Hospital District | Psychiatry & Neurology | 1310 N Roan St, Johnson City, TN 37601-3942 | 2019-11-04 |
| 1942696158 | Bill Mccartt | Psychiatry & Neurology | 267 Laurel Cyn, Johnson City, TN 37615-4727 | 2015-04-14 |
| 1194146894 | Medical Education Assistance Corporation | Psychiatry & Neurology | 2109 W Market St Ste 140, Johnson City, TN 37604 | 2013-12-23 |
| 1538450408 | Faith A Aimua | Psychiatry & Neurology | 206 Princeton Rd Ste 18, Johnson City, TN 37601-2025 | 2011-04-27 |
| 1972753663 | Marina S.l. Colombo | Psychiatry & Neurology | Lamont and Veterans Way. Mountain Home., James H Quillen Va Med Center., Johnson City, TN 37684 | 2008-09-30 |
| 1588853295 | Mountain States Health Alliance | Psychiatry & Neurology | 508 Princeton Commons, Suite 403, Johnson City, TN 37601-2060 | 2007-10-18 |
| 1639370950 | Marian Eleanor Steen | Psychiatry & Neurology | 607 E Watauga Ave Apt 3, Johnson City, TN 37601-4071 | 2007-05-31 |
| 1497967897 | David Lionel Forester | Psychiatry & Neurology | 209 E Unaka Ave, Johnson City, TN 37601-4625 | 2007-05-06 |
| 1407982762 | William Arthur Wiley Jr. | Psychiatry & Neurology | 112 E Myrtle Avenue, Suite 506, Johnson City, TN 37601-8600 | 2007-02-23 |
| 1356417661 | Jill Baron | Psychiatry & Neurology | 804 Valley Plaza, Johnson City, NY 13790 | 2006-11-28 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.