Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Critical Care Johnson City, MSMG Critical Care JCMC, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILOGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
400 N STATE OF FRANKLIN RD, ROOM 2746, JOHNSON CITY, TN 37604-6035
(423) 431-2727
(423) 431-6715
Mailing address
400 N STATE OF FRANKLIN RD, ROOM 2746, JOHNSON CITY, TN 37604-6035
(423) 431-2727
(423) 431-6715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020487815
DEPARTMENT OF LABOR
TN
05
—
1356472880
—
VA
05
—
1504269
—
TN
05
—
5908527
—
NC
05
—
7100013020
—
KY
01
—
CA5744
RAILROAD MEDICARE
TN
Enumeration date
03/08/2007
Last updated
05/02/2025
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