# BLUE RIDGE MEDICAL MANAGEMENT CORPORAITON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MSMG Wound Care JC, BHMA Wound Care JCMC, Ballad Health Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245685858
- **Authorized official:** CARL S KILGORE (PRESIDENT/CEO)
- **Authorized official phone:** (423) 302-3051

## Contact information

- **Practice address:** 408 N STATE OF FRANKLIN RD, STE 12, JOHNSON CITY, TN 37604-6089
- **Practice address phone:** (423) 431-2650
- **Practice address fax:** (423) 431-2659
- **Mailing address:** 408 N STATE OF FRANKLIN RD, STE 12, JOHNSON CITY, TN 37604-6089
- **Mailing address phone:** (423) 431-2650
- **Mailing address fax:** (423) 431-2659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2016
- **Last updated:** 05/02/2025