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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1316357593


NPI Information

NPI: 1316357593
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: MSMG EXTENDED CARE JC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
408 N STATE OF FRANKLIN RD
SUITE 24 A
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-1810
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is an internal medicine in Johnson City, TN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1316357593. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Msmg Extended Care Jc.

The provider's business location address is:

408 N STATE OF FRANKLIN RD
SUITE 24 A
JOHNSON CITY, TN
ZIP 37604-089
Phone: (423) 431-1810
Fax: (423) 431-1811

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 4/28/2014 and was last updated on 7/8/2015.


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
1207Q00000XFamily MedicineNo
2363A00000XPhysician AssistantNo
3363L00000XNurse PractitionerNo
4207R00000XInternal MedicineYes

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
21316357593MEDICAIDVIRGINIA
31534067MEDICAIDTENNESSEE

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

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