# BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ballad Health Medical Associates, MSMG HIMA JCMC, BHMA Hospitalists JCMC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912137506
- **Authorized official:** CARL STEVEN KILGORE (PRESIDENT)
- **Authorized official phone:** (423) 302-3051

## Contact information

- **Practice address:** 408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
- **Practice address phone:** (423) 431-1810
- **Practice address fax:** (423) 431-1811
- **Mailing address:** 400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
- **Mailing address phone:** (423) 431-1810
- **Mailing address fax:** (423) 431-1811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | TN | — |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/17/2009
- **Last updated:** 08/07/2023