| NPI | 1164794525 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2012-02-01 |
| Last Updated | 2019-03-28 |
| Authorized Official | Carl Kilgore President Phone: 4233023051 |
| Mailing Address | 2205 Pavilion Dr, Suite 201b Kingsport, TN 37660-4641 United States Phone: (423) 857-7650 | Fax: (423) 857-7655 📍 View Map |
| Primary Practice Address | 2205 Pavilion Dr, Suite 201b Kingsport, TN 37660-4641 United States Phone: (423) 857-7650 | Fax: (423) 857-7655 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | TN | 020487837 | Department of Labor |
| MEDICAID | VA | 1164794525 | - |
| MEDICAID | TN | 1528656 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207RP1001X – Internal Medicine, Pulmonary Disease | - | - |
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About NPI 1164794525
Blue Ridge Medical Management Corporation is an organization registered in the CMS NPPES NPI Registry with NPI number 1164794525. The primary specialty listed is Internal Medicine, Pulmonary Disease. The organization is located in Kingsport, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-02-01. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1164794525?
NPI 1164794525 belongs to Blue Ridge Medical Management Corporation, a Internal Medicine, Pulmonary Disease in Kingsport, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1164794525 active?
The current status of NPI 1164794525 in the NPPES registry is Active. The record was last updated on 2019-03-28.
What specialty is NPI 1164794525?
NPI 1164794525 is classified under the taxonomy Internal Medicine, Pulmonary Disease. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1164794525?
You can verify NPI 1164794525 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1164794525?
The primary practice address on file for NPI 1164794525 is 2205 Pavilion Dr, Kingsport, TN 37660-4641. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1164794525 issued?
NPI 1164794525 was first issued (enumerated) on 2012-02-01. The NPPES record was last updated on 2019-03-28.
Practice Location Map
Blue Ridge Medical Management Corporation is located at 2205 Pavilion Dr, Kingsport, TN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Blue Ridge Medical Management Corporation. All records sourced from the CMS NPPES registry.