BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI# 1730610981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730610981 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Other Organization Name | MSMG CARDIOLOGY RURAL RETREAT |
| Practice Address |
7021 W Lee Hwy Ste C2 Rural Retreat VA 24368-2933 |
| Practice Telephone | 2762583740 |
| Practice Fax Number | 2762583745 |
| Mailing Telephone | 2762583740 |
| Mailing Fax Number | 2762583745 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |
| Authorized Official Name | MR. CARL STEVEN KILGORE (PRESIDENT/CEO) |
| Authorized Official Telephone | 4239155185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MSMG Cardiology Rural Retreat | 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 |
7021 W LEE HWY STE C2 |
| City | RURAL RETREAT |
| State | VA |
| Zip Code | 24368-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649213315 | Charles Phillip Hurlburt | Family Medicine | 7021 W Lee Hwy, Suite C, Rural Retreat, VA 24368-2933 | 2006-06-13 |
| 1124443957 | Cassidy Hensley | Nurse Practitioner | 7021 W Lee Hwy, Suite C, Rural Retreat, VA 24368-2933 | 2014-03-04 |
| 1356651897 | Jan Doane Rasnake | Nurse Practitioner | 7021 W Lee Hwy, Suite C, Rural Retreat, VA 24368-2933 | 2010-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770914053 | Sondra Alicia Monahan | Occupational Therapy Assistant | 694 Ward Branch Road, Rural Retreat, VA 24368 | 2013-12-11 |
| 1134466055 | Jeanie Lea Gonzalez | Pharmacist | 7059 West Lee Hwy, Rural Retreat, VA 24368 | 2013-01-11 |
| 1275805863 | Family Preservation Services, Inc. | Community/Behavioral Health | 514 North Main Street, Rural Retreat, VA 24368 | 2012-01-30 |
| 1871633024 | Lee Anne Francis Lefler | Pharmacy Technician | 7059 West Lee Highway, Rural Retreat, VA 24368 | 2007-02-07 |
| 1457446262 | Stampers Health Enterprises Inc | Durable Medical Equipment & Medical Supplies | 544 North Main St, Rural Retreat, VA 24368 | 2006-10-04 |
| 1356445589 | Michael W. Spraker | Dentist | 7061 West Lee Hwy, Rural Retreat, VA 24368 | 2006-09-08 |
| 1407804420 | Holly Lynn Smith | Legal Medicine | 306 South Main St., Rural Retreat, VA 24368 | 2006-05-04 |
| 1750725024 | Blue Ridge Medical Management Corporation | Orthopaedic Surgery | 7021 West Lee Highway, Suite B, Rural Retreat, VA 24368 | 2013-04-17 |
| 1811269640 | Blue Ridge Medical Management Corporation | Nurse Practitioner | 7021 West Lee Highway, Suite B, Rural Retreat, VA 24368 | 2012-02-09 |
| 1447543996 | Blue Ridge Medical Management Corporation | Family Medicine | 7021 West Lee Highway, Suite C, Rural Retreat, VA 24368 | 2011-05-17 |
| Find all providers in zip 24368 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1407482102 | Careclix Inc | Internal Medicine | 206 N Washington St Ste 100, Alexandria, VA 22314-2534 | 2020-03-14 |
| 1962046763 | Southpark Vascular Center | Internal Medicine | 445 Charles H Dimmock Pkwy Ste 101, Colonial Heights, VA 23834-2990 | 2019-11-05 |
| 1205496866 | United Diagnostic Services LLC | Internal Medicine | 4115 Annandale Rd Ste 301d, Annandale, VA 22003-2500 | 2019-06-17 |
| 1790348365 | Virginia Hospital Center Physician Group LLC | Internal Medicine | 1625 N George Mason Dr Ste 354, Arlington, VA 22205-3687 | 2019-04-18 |
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1083133144 | Community Cardiology | Internal Medicine | 43 Rives Rd Ste 201, Petersburg, VA 23805-9255 | 2017-09-11 |
| 1306361803 | Stateline Heart and Vascular Health, Inc | Internal Medicine | 312 Fairy Street Ext Ste 101, Martinsville, VA 24112-1912 | 2017-08-07 |
| 1265954747 | Sentara Medical Group | Internal Medicine | 1933 Edwin Dr Ste 208a, Chesapeake, VA 23322-6531 | 2017-07-17 |
| 1003366618 | Bluefield Vascular Center | Internal Medicine | 970 Leatherwood Ln, Bluefield, VA 24605-2047 | 2016-10-06 |
| 1770947806 | Rajiv Ashok Kabadi | Internal Medicine | Vcuhs Department of Cards Fellowship, 980509, 1250 E. Marshall Street, Richmond, VA 23298-0509 | 2016-04-05 |
| Find all providers with the same taxonomy | ||||
| City | RURAL RETREAT |
| Zip Code | 24368 |
Please comment or provide details below to improve the information on BLUE RIDGE MEDICAL MANAGEMENT CORPORATION.
| 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.