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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1144458332


NPI Information

NPI: 1144458332
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: MSMG CVT KPT

Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
2205 PAVILION DR
SUITE 102
KINGSPORT, TN
ZIP 37660
Phone: (423) 929-7393
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a thoracic surgery cardiothoracic vascular surgery in Kingsport, TN. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1144458332. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Msmg Cvt Kpt.

The provider's business location address is:

2205 PAVILION DR
SUITE 102
KINGSPORT, TN
ZIP 37660-641
Phone: (423) 929-7393
Fax: (423) 929-1427

The provider's authorized official is Carl Steven Kilgore .
The authorized official title is President and has the following contact phone number (423) 915-5100.

The enumeration date for this NPI number is 6/25/2009 and was last updated on 10/27/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician AssistantNo
2363AS0400XPhysician AssistantSurgicalNo
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13709285MEDICARE PINTENNESSEE
21515098MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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