Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG HIMA JMH, Ballad Health Medical Associates, BHMA Hospitalists JMH
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, FOURTH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Mailing address
16000 JOHNSTON MEMORIAL DR, FOURTH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101246669
VA
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
VA
363L00000X
Nurse Practitioner
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104171826
—
NC
05
—
1104171826
—
VA
05
—
1530896
—
TN
01
—
4348719
BLUECARE
TN
01
—
614862402
DEPARTMENT OF LABOR
VA
01
—
DF7910
RR MEDICARE
VA
01
—
DF9105
RR MEDICARE
VA
Enumeration date
07/18/2012
Last updated
03/28/2019
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