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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1487690434


NPI Information

NPI: 1487690434
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2205 PAVILION DR
SUITE 201
KINGSPORT, TN
ZIP 37660
Phone: (423) 857-7650
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a cardiovascular disease internal medicine in Kingsport, TN. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1487690434. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ballad Health Medical Associates.

The provider's business location address is:

2205 PAVILION DR
SUITE 201
KINGSPORT, TN
ZIP 37660-641
Phone: (423) 857-7650
Fax: (423) 857-7655

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

The enumeration date for this NPI number is 6/20/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseYes

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
1CA5744OTHERTENNESSEERAILROAD MEDICARE
21487690434MEDICAIDVIRGINIA
3020487806OTHERTENNESSEEDEPARTMENT OF LABOR
47100080500MEDICAIDKENTUCKY
53716299MEDICAIDTENNESSEE

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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