| Blue Ridge Medical Management Corporation | |
|
400 N State Of Franklin Rd Room 2746 Johnson City TN 37604-6035 | |
| (423) 431-2727 | |
| (423) 431-6715 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 N State Of Franklin Rd, Johnson City, Tennessee |
| Authorized Official Name and Position | Carl Steven Kilogore (PRESIDENT) |
| Authorized Official Contact | 4233023051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Medical Management Corporation 400 N State Of Franklin Rd Room 2746 Johnson City TN 37604-6035 Ph: (423) 431-2727 | Blue Ridge Medical Management Corporation 400 N State Of Franklin Rd Room 2746 Johnson City TN 37604-6035 Ph: (423) 431-2727 |
| NPI Number | 1356472880 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 05/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356472880 | NPI | - | NPPES |
| 1504269 | Medicaid | TN | |
| 5908527 | Medicaid | NC | |
| 1356472880 | Medicaid | VA | |
| 020487815 | Other | TN | DEPARTMENT OF LABOR |
| 7100013020 | Medicaid | KY | |
| CA5744 | Other | TN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | (* (Not Available)) | Secondary |
Mcc, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 E Watauga Ave, Johnson City, TN 37601 Phone: 423-722-8446 Fax: 423-722-5674 | |
Medical Education Assistance Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 W Walnut St, Johnson City, TN 37604 Phone: 423-439-6464 Fax: 423-439-7118 | |
Wyche & Wyche, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2406 Susannah St, Johnson City, TN 37601 Phone: 423-282-2542 Fax: 423-282-5447 | |
Imperial Healthcare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1604 Lamons Ln Ste 230, Johnson City, TN 37604 Phone: 423-930-5168 Fax: 423-328-0193 | |
Blue Ridge Medical Management Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 N State Of Franklin Rd, Suite 135b, Johnson City, TN 37604 Phone: 423-431-4866 Fax: 423-431-2372 | |
New Life Chiropractic And Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 514 E Watauga Ave, Johnson City, TN 37601 Phone: 423-928-4101 | |
Blue Ridge Medical Management Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 N State Of Franklin Rd, Ste 301a, Johnson City, TN 37604 Phone: 423-431-6816 Fax: 423-431-2983 |