Gordon S Bontrager (NPI# 1780919829, PAC ID# 4486792769) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1780919829 |
| PAC ID by PECOS | 4486792769 |
| Professional Enrollment ID | I20150211000727 |
| Full Name | Gordon S Bontrager |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Address |
310 N State of Franklin Suite 301a Johnson City TN 37604-0000 |
| Phone Number | 4234316816 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9739099441 |
| Number of Group Practice Members | 310 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 | 4234316816 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 310 N State of Franklin, Johnson City, TN 37604-0000 | 4234316816 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 400 N State of Franklin, Room Lk015, Johnson City, TN 37604-0000 | 4234315965 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 400 N State of Franklin, Johnson City, TN 37604-0000 | 4234315965 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 403 N State of Franklin Rd, Johnson City, TN 37604-0000 | 4234317042 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 395 Forest Cir, Suite 100, Jonesborough, TN 37659-1439 | 4237530721 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 395 Forest Cir, Jonesborough, TN 37659-1439 | 4237530721 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 4600 Fort Henry Dr, Kingsport, TN 37663-2617 | 4232243950 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Physicians | 289 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deneene R Booth | Anesthesiology | Blue Ridge Medical Management Corporation | 601 Campus Dr, Abingdon, VA 24210-9700 |
| Shasta Nicole Bowens | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2000 Brookside Dr, Suite 3, Kingsport, TN 37660-4627 |
| Luc Jasmin | Neurosurgery | Blue Ridge Medical Management Corporation | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 |
| Sandra Michelle Sparks | Nurse Practitioner | Blue Ridge Medical Management Corporation | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6529 |
| Rebecca Sacora | Family Medicine | Blue Ridge Medical Management Corporation | 2030 Temple Hill Rd, Suite B, Erwin, TN 37650-8721 |
| Leslie Renee Barlow | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1201 Snider St, Marion, VA 24354-4221 |
| Sheila Ann Matherly | Nurse Practitioner | Blue Ridge Medical Management Corporation | 404 Bemberg Rd, Elizabethton, TN 37643-2938 |
| Melanie Hagerman | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2 Professional Park Dr, Suite 11, Johnson City, TN 37604-6584 |
| Jessica Glasscock Mcgahey | Nurse Practitioner | Blue Ridge Medical Management Corporation | 400 N State of Franklin, Room Lk015, Johnson City, TN 37604-0000 |
| Amanda Elizabeth Loughlin | Nurse Practitioner | Blue Ridge Medical Management Corporation | 71 S Flannagan Ave, Lebanon, VA 24266 |
| Street Address |
310 N STATE OF FRANKLIN SUITE 301A |
| City | JOHNSON CITY |
| State | TN |
| Zip | 37604-0000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles W Raudat | Thoracic Surgery | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Steven E Norman | Family Practice | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Richard K Reed | Internal Medicine | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| James J Casey Jr. | Physician Assistant | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Terry C Borel | Psychiatry | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Donald R Lovelace | Obstetrics/gynecology | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Robert Edmund Walter | Internal Medicine | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| John W Boyle Iii | Obstetrics/gynecology | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Malcolm Mathews Iii | Medical Oncology | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Deanna L Patterson | Nurse Practitioner | Blue Ridge Medical Management Corporation | 310 N State of Franklin, Suite 301a, Johnson City, TN 37604-0000 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elnora Spradling | Medical Oncology | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Stephen A Cradic | Chiropractic | 206 Headtown Rd, Suite 100, Jonesbourough, TN 37604 | |
| Shweta Kharalkar | Hospitalist | Blue Ridge Medical Management Corporation | 408 N State of Franklin, Suite 24, Johnson City, TN 37604 |
| Devapiran Jaishankar | Medical Oncology | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Jamie E Carnell | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Sakshi Singal | Hematology/oncology | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Selma Zukic Kominek | Neurosurgery | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Kanishka Chakraborty | Medical Oncology | Blue Ridge Medical Management Corporation | 1 Professional Pk Dr, Suite 21, Johnson City, TN 37604 |
| Jessica Glasscock Mcgahey | Nurse Practitioner | Blue Ridge Medical Management Corporation | 400 N State of Franklin, Room Lk015, Johnson City, TN 37604-0000 |
| Adam Horn | Nurse Practitioner | Blue Ridge Medical Management Corporation | 403 N State of Franklin Rd, Johnson City, TN 37604-0000 |
| Find all physicians in zip 37604 | |||
| City | JOHNSON CITY |
| Zip Code | 37604 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | JOHNSON CITY + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Gordon S Bontrager.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.