Tariq Z Haddadin (NPI# 1003880295, PAC ID# 9436196516) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1003880295 |
| PAC ID by PECOS | 9436196516 |
| Professional Enrollment ID | I20050727000386 |
| Full Name | Tariq Z Haddadin |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Address |
1019 W Oakland Ave Suite 1 Johnson City TN 37604-2357 |
| Phone Number | 4239155000 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1996 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 9739099441 |
| Number of Group Practice Members | 316 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440063 | JOHNSON CITY MEDICAL CENTER |
| 440184 | FRANKLIN WOODS COMMUNITY HOSPITAL |
| 440018 | SYCAMORE SHOALS HOSPITAL |
| 440176 | INDIAN PATH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 | 4239155000 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 4234314847 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 400 N State of Franklin Rd, Rm 2746, Johnson City, TN 37604-6035 | 4234312727 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| 410 N State of Franklin Rd, Suite 120, Johnson City, TN 37604-6035 | 4234312350 | 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 |
1019 W OAKLAND AVE SUITE 1 |
| City | JOHNSON CITY |
| State | TN |
| Zip | 37604-2357 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle R Estes | Pediatric Medicine | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Steven J Mclaughlin | Physician Assistant | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Natalie C Bateson | Physician Assistant | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Larry M Stevens Ii | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Gregory Houston Miller | Cardiovascular Disease (cardiology) | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Amanda B Stevens | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Julia Davenport | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Hannah Audia | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Brittney Terry | Pediatric Medicine | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| Lauren T Blankenship | Physician Assistant | Blue Ridge Medical Management Corporation | 1019 W Oakland Ave, Suite 1, Johnson City, TN 37604-2357 |
| 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 | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | JOHNSON CITY + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Tariq Z Haddadin.
| 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.