BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1104171826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104171826 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | BALLAD HEALTH MEDICAL ASSOCIATES |
| Practice Address |
16000 Johnston Memorial Dr Fourth Floor Abingdon VA 24211-7664 |
| Practice Telephone | 2762584050 |
| Practice Fax Number | 2762584056 |
| Mailing Telephone | 2762584050 |
| Mailing Fax Number | 2762584056 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | CARL STEVEN KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4233023051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | VA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363L00000X | Nurse Practitioner | VA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 207R00000X | Internal Medicine | 0101246669 | VA | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1104171826 | 05 | |
| VA | RR MEDICARE | DF7910 | 01 |
| VA | RR MEDICARE | DF9105 | 01 |
| TN | 1530896 | 05 | |
| NC | 1104171826 | 05 | |
| TN | BLUECARE | 4348719 | 01 |
| VA | DEPARTMENT OF LABOR | 614862402 | 01 |
| Other Name | Type Code |
|---|---|
| Ballad Health Medical Associates | Doing Business As Name - Organization |
| BHMA Hospitalists JMH | Other Name - Individual/Organization |
| MSMG HIMA JMH | 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 |
16000 JOHNSTON MEMORIAL DR FOURTH FLOOR |
| City | ABINGDON |
| State | VA |
| Zip Code | 24211-7664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629075403 | Steven Douglas Sikora | Emergency Medicine | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7659 | 2005-07-07 |
| 1306461678 | Erik Richardson | Family Medicine | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-06-12 |
| 1528682523 | Trevor Chase Elswick | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-06-04 |
| 1477176543 | Martin Earl Cook | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-05-24 |
| 1689295230 | Steven T Cook | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-05-05 |
| 1073134862 | Kaleigh Erin Hale Almeida | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-05-03 |
| 1174154413 | Eric Anderson | Nurse Anesthetist, Certified Registered | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2020-01-27 |
| 1154972701 | Samantha Palmer | Nurse Practitioner | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2019-09-25 |
| 1700445608 | Ashwin Chandra | Family Medicine | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2019-06-13 |
| 1679133540 | Jerod William Bachman | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2019-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386087245 | Abingdon Apothecary, Inc. | Pharmacy | 26100 Lee Highway, Abingdon, VA 24211 | 2013-04-10 |
| 1255671152 | Mac's Medical Equipment and Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 26102 Lee Highway, Abingdon, VA 24211 | 2013-03-01 |
| 1316290737 | Falcon Pharmacy | Pharmacy | 795 Cummings Street, Abingdon, VA 24211 | 2012-10-23 |
| 1407027402 | Carla M. Keene, D.d.s. | Dentist | 15189 Porterfield Highway, Abingdon, VA 24211 | 2008-03-18 |
| 1215001045 | Bernard A Tisdale Md PC | Radiology | 26079 Lee Highway, Abingdon, VA 24211 | 2006-11-20 |
| 1982670048 | Jeffrey Allen Mccraw | Anesthesiology | 351 North Court St, Abingdon, VA 24211 | 2006-02-27 |
| 1356320881 | Joseph A Brown | Internal Medicine | 16000 Johnston Memorial Drive, Suite 304, Abingdon, VA 24211 | 2006-01-12 |
| 1922667435 | Saman Saeed | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Drive, Abingdon, VA 24211 | 2019-06-08 |
| 1558891101 | Katie Danielle Buckner | Family Medicine | 16000 Johnston Memorial Drive, Abingdon, VA 24211 | 2017-06-15 |
| 1316359003 | Beth Morley | Nurse Practitioner | 15051 Harmony Hills Ln, Abingdon, VA 24211 | 2014-05-29 |
| Find all providers in zip 24211 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073042800 | Virginia Pac Services PC | Hospitalist | 15051 Harmony Hills Ln, Abingdon, VA 24211-7661 | 2017-06-06 |
| 1386834547 | Johnston Memorial Hospital | Hospitalist | 16000 Johnston Memorial Dr, Abingdon, VA 24211-7664 | 2007-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447811443 | S. Wyatt, Pllc | Hospitalist | 7457 Mook Ct, Mechanicsville, VA 23111-1452 | 2019-06-21 |
| 1568028082 | Daniel Kamara | Hospitalist | 1102 Commerce St # H, Lynchburg, VA 24504-1719 | 2019-05-10 |
| 1235521667 | Medical Solutions of Virginia, Inc | Hospitalist | 717 Elm Forest Ct, Chesapeake, VA 23322-7589 | 2015-02-23 |
| 1043521800 | Ashish Patel | Hospitalist | 7151 Jahnke Rd, Richmond, VA 23225 | 2010-06-27 |
| 1457672024 | Baidaa N Sullivani | Hospitalist | 3136 Turnberry Cir, Charlottesville, VA 22911-7489 | 2010-06-18 |
| 1922323435 | Lily O Otolorin | Hospitalist | 2337 Kew Gardens Dr, Woodbridge, VA 22191-6577 | 2010-03-29 |
| 1700012473 | Abreham Baye Feleke | Hospitalist | Mcguire Va Medical Center 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2009-06-08 |
| 1134363427 | Yuri Maricich | Hospitalist | 977 Seminole Trl, #357, Charlottesville, VA 22901-2824 | 2009-04-30 |
| 1174790588 | James Hyun Jin So | Hospitalist | 4000 Barringer Ln, Apt 1938, Richmond, VA 23233-1158 | 2008-05-14 |
| 1861680662 | Riversbend Hospitalists P.C. | Hospitalist | 835 Club Ridge Ter, Chester, VA 23836-2746 | 2007-10-06 |
| Find all providers with the same taxonomy | ||||
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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.