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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1659476992


NPI Information

NPI: 1659476992
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: DBA INDIAN PATH MEDICAL CENTER

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
2000 BROOKSIDE DR
7TH FLOOR GERIATRIC PSYCHIC UNIT
KINGSPORT, TN
ZIP 37660
Phone: (423) 857-7740
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a psychiatry psychiatry neurology in Kingsport, TN. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1659476992. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dba Indian Path Medical Center.

The provider's business location address is:

2000 BROOKSIDE DR
7TH FLOOR GERIATRIC PSYCHIC UNIT
KINGSPORT, TN
ZIP 37660-627
Phone: (423) 857-7740
Fax: (423) 857-7711

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) 915-5185.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 8/22/2020.


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
12084P0800XPsychiatry & NeurologyPsychiatryYes

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
13732722MEDICAIDTENNESSEE

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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