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Contact Information

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN37604-6034
 Phone: 423-431-7047
 Fax: 423-979-0569
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for BLUE RIDGE MEDICAL MANAGEMENT CORPORATION · (Female)

NPI Number 1326058272
Status Active
Credentials
Entity Individual
Enumeration date 08/09/2006
Last updated 03/29/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC Medicaid 5908711
  • TN Medicaid 3377132
  • VA Medicaid 1326058272
  • Other CA5744 RR MEDICARE
  • TN Other 801453000 MAGELLAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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