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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1548270879


NPI Information

NPI: 1548270879
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
2002 BROOKSIDE DR
STE 300
KINGSPORT, TN
ZIP 37660
Phone: (423) 392-6370
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is an obstetrics gynecology in Kingsport, TN. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1548270879. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ballad Health Medical Associates.

The provider's business location address is:

2002 BROOKSIDE DR
STE 300
KINGSPORT, TN
ZIP 37660-634
Phone: (423) 392-6370
Fax: (423) 392-6081

The provider's authorized official is Carl Steven 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 8/9/2006 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
1207V00000XObstetrics & GynecologyYes

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
11548270879MEDICAIDVIRGINIA
23709288MEDICAIDTENNESSEE

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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