Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Behavioral Health SSH, BHMA Behavioral Health Johnson City, Ballad Health Medical Associates, MSMG BEH HLTH JC
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569
Mailing address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326058272
—
VA
05
—
3377132
—
TN
05
—
5908711
—
NC
01
—
801453000
MAGELLAN
TN
01
—
CA5744
RR MEDICARE
—
Enumeration date
08/09/2006
Last updated
03/29/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us