BLUE RIDGE MEDICAL MANAGGEMENT CORPORATION NPI 1649518309

NPI Information

NPI: 1649518309
Provider Name: BLUE RIDGE MEDICAL MANAGGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
4600 FORT HENRY DR
KINGSPORT, TN
ZIP 37663
Phone: (423) 224-3950
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BLUE RIDGE MEDICAL MANAGGEMENT CORPORATION is an urgent care clinic center in Kingsport, TN. BLUE RIDGE MEDICAL MANAGGEMENT CORPORATION NPI is 1649518309. The provider is registered as an organization entity type.
The provider Is Doing Business As Ballad Health Medical Associates.

The provider's business location address is:

4600 FORT HENRY DR
KINGSPORT, TN
ZIP 37663
Phone: (423) 224-3950
Fax: (423) 224-3959

The provider's authorized official is Carl S Kilgore .
The authorized official title is President and has the following contact phone number (423) 302-3051.

The enumeration date for this NPI number is 1/30/2013 and was last updated on 3/29/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care			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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1532903	MEDICAID	TENNESSEE
2	1649518309	MEDICAID	VIRGINIA
3	CA5744	OTHER	TENNESSEE	RAILROAD MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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