BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1356472880

NPI Information

  • NPI: 1356472880
  • Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • :
  • Address: 400 N STATE OF FRANKLIN RD
    ROOM 2746
    JOHNSON CITY, TN
    ZIP 37604
  • Phone: (423) 431-2727

Map and Directions

Get Directions

NPI Details

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is an internal medicine in Johnson City, TN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1356472880. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

400 N STATE OF FRANKLIN RD
ROOM 2746
JOHNSON CITY, TN
ZIP 37604-035
Phone: (423) 431-2727
Fax: (423) 431-6715

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

The enumeration date for this NPI number is 3/8/2007 and was last updated on 5/2/2025.

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
1207RC0200XInternal MedicineCritical Care MedicineNo
2207R00000XInternal 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
6CA5744OTHERTENNESSEERAILROAD MEDICARE
57100013020MEDICAIDKENTUCKY
4020487815OTHERTENNESSEEDEPARTMENT OF LABOR
31356472880MEDICAIDVIRGINIA
25908527MEDICAIDNORTH CAROLINA
11504269MEDICAIDTENNESSEE

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI