BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1275761538

NPI Information

NPI: 1275761538
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Internal Medicine - 207RX0202X
Entity Type: Organization

Specialization: Medical Oncology

Address:
1 PROFESSIONAL PARK DR
STE 21
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 232-6900
Get Directions

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a medical oncology internal medicine in Johnson City, TN. The provider is an internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1275761538. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Ballad Health Medical Associates.

The provider's business location address is:

1 PROFESSIONAL PARK DR
STE 21
JOHNSON CITY, TN
ZIP 37604-587
Phone: (423) 232-6900
Fax: (423) 232-6903

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

The enumeration date for this NPI number is 6/25/2009 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RX0202X	Internal Medicine	Medical Oncology			Yes

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
1	CA5744	OTHER	TENNESSEE	RAILROAD MEDICARE
2	1275761538	MEDICAID	VIRGINIA
3	020487822	OTHER	TENNESSEE	DEPARTMENT OF LABOR
4	1516423	MEDICAID	TENNESSEE

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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