OrganizationBlue Ridge Medical Management Corporation(Ballad Health Medical Associates)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653(423) 224-3900PECOS EnrollmentBased on the most recent information from CMS, provider Blue Ridge Medical Management Corporation does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1730401209Provider TypeOrganizationFull NameBlue Ridge Medical Management CorporationOther NameBallad Health Medical AssociatesSubpartNoEnumeration Date2/24/2010Last Updated3/29/2019Contact InformationPractice LocationPractice Address2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653Phone(423) 224-3900Fax(423) 224-3901Mailing LocationMailing Address2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653Phone(423) 224-3900Fax(423) 224-3901Authorized OfficialNameKilgore, Carl Steve (President)Phone(423) 302-3051Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDCA5744DescriptionOtherIssuerRAILROAD MEDICARETennesseeID1730401209DescriptionMedicaidIssuerUnlistedVirginiaID623293300DescriptionOtherIssuerDEPARTMENT OF LABORTennesseeID3719388DescriptionMedicaidIssuerUnlistedTennessee