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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1093120222


NPI Information

NPI: 1093120222
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

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

Specialization: Psychiatry

Address:
403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-7047
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a psychiatry psychiatry neurology in Johnson City, 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 1093120222. 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:

403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604-034
Phone: (423) 431-7047
Fax: (423) 979-0569

The provider's authorized official is Carl S 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 6/26/2014 and was last updated on 3/28/2019.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q013746MEDICAIDTENNESSEE
21093120222MEDICAIDVIRGINIA

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: 5/5/2024

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