NPI 1134500218 · live from the CMS NPI Registry
Blue Ridge Medical Management Corporation
Internal Medicine in Johnson City, TN. National Provider Identifier 1134500218, active.
NPI record
| NPI | 1134500218 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 408 N State Of Franklin Rd, Suite 31c, Johnson City, TN 37604 |
| Practice phone | 423-431-4946 |
| Enumerated | June 15, 2015 |
| Last updated | May 2, 2025 |
| Authorized official | Carl Kilgore, President |
| Other names | Ballad Health Medical Associates; Msmg Pediatric Neurology; Bhma Pediatric Neurology Jc |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Neurodevelopmental Disabilities | 2080P0008X | — |
| Nurse Practitioner, Family | 363LF0000X | — |
| Internal Medicine primary | 207R00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.