Msmg Extended Care Jc

LBN: Blue Ridge Medical Management Corporation
Msmg Extended Care Jc is an health care organization with primary practice located at 408 N State Of Franklin Rd Suite 24 A, Johnson City TN 37604-6089. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Blue Ridge Medical Management Corporation can be contacted via phone (423) 431-1810, or through Kilgore, Carl Steven via phone (423) 915-5100.

Contact Information

Primary practice address
408 N State Of Franklin Rd Suite 24 A Johnson City TN 37604-6089
Phone: (423) 431-1810
Fax: (423) 431-1811
Website:
Map and Directions
Authorized official contact:
Name: Kilgore, Carl Steven
Phone: (423) 915-5100

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1316357593
LBN Legal business name Blue Ridge Medical Management Corporation
DBA Doing business as Msmg Extended Care Jc
Authorized official Kilgore, Carl Steven
Entity Organization
Organization subpart 1 No
Enumeration date Apr 28th, 2014
Last updated Jul 8th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316357593 NPPES
Virginia MEDICAID 1316357593
Virginia MEDICAID 1534067

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