Look up the most recent NPI and PECOS records

Blue Ridge Medical Management Corp

(Ballad Health Medical Associates)

Family Medicine

Allopathic & Osteopathic Physicians

1905 American Way, Kingsport, TN 37660-5882

PECOS Enrollment

Based on the most recent information from CMS, provider Blue Ridge Medical Management Corp does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 4:18 PM.

Profile Details

Provider ID
1528723251
Provider Type
Organization
Full Name
Blue Ridge Medical Management Corp
Other Name
Ballad Health Medical Associates

Subpart
No
Enumeration Date
11/8/2021
Last Updated
10/1/2024

Contact Information

Practice Location

1905 American Way, Kingsport, TN 37660-5882

(423) 578-8451

(423) 230-8224

Mailing Location

1021 W Oakland Ave Ste 310, Johnson City, TN 37604-2192

(423) 952-2111

(423) 282-1657

Authorized Official

Kilgore, Carl (Executive)

(423) 302-3051

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer

Blue Ridge Medical Management Corp

(Ballad Health Medical Associates)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Blue Ridge Medical Management Corp

Metcalf, Aaron K

Kliesch, John F

Switalski, Remigiusz Jan

Funke, Robert Harold

Vaughn, Jeffrey

Dr Susanne Toyne Md Pllc

Mcqueen, Kelly G

Hager, Shelton

Ananthula, Parvati