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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1811378854


NPI Information

NPI: 1811378854
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Pediatrics - 2080P0203X
Entity Type: Organization

Specialization: Pediatric Critical Care Medicine

Address:
408 N STATE OF FRANKLIN RD
SUITE 31D
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-4946
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a pediatric critical care medicine pediatrics in Johnson City, TN. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1811378854. 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:

408 N STATE OF FRANKLIN RD
SUITE 31D
JOHNSON CITY, TN
ZIP 37604-089
Phone: (423) 431-4946
Fax: (423) 431-4947

The provider's authorized official is Carl Steve 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 6/16/2015 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
12080P0203XPediatricsPediatric Critical Care 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
1Q013694MEDICAIDTENNESSEE
21811378854MEDICAIDVIRGINIA

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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