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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1811269640


NPI Information

NPI: 1811269640
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: MSMG URO RURL

Classification: Urology - 208800000X
Entity Type: Organization
Address:
7021 WEST LEE HIGHWAY
SUITE B
RURAL RETREAT, VA
ZIP 24368
Phone: (276) 783-5400
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is an urology in Rural Retreat, VA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1811269640. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Msmg Uro Rurl.

The provider's business location address is:

7021 WEST LEE HIGHWAY
SUITE B
RURAL RETREAT, VA
ZIP 24368
Phone: (276) 783-5400
Fax: (276) 783-5521

The provider's authorized official is Carl Steven Kilgore .
The authorized official title is President and has the following contact phone number (423) 915-5116.

The enumeration date for this NPI number is 2/9/2012 and was last updated on 2/14/2017.


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
1208800000XUrologyYes
2363LF0000XNurse PractitionerFamily0024166068VIRGINIANo

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
1C09112MEDICARE PINVIRGINIA
21811269640MEDICAIDVIRGINIA

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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