Blue Ridge Medical Management Corporation
NPI 1619349578ActiveOrganization· Internal Medicine· Johnson City, TN
Internal Medicine in Johnson City, Tennessee, registered in NPPES in October 2015. The authorized official on file is Carl Steven Kilgore, President.
Overview
| NPI | 1619349578 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 30, 2015 |
| Last updated in NPPES | May 2, 2025 |
| Certified by provider | May 2, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Pediatrics, Pediatric Gastroenterology | 2080P0206X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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