National Provider Identifier Database

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
2300 PAVILION DR
KINGSPORT, TN37660-4622
Phone: 423-392-5500
Fax: 423-392-5597
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

NPI Number 1659475374
Legal business name
LBN
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Authorized official C. KILGORE - (SENIOR VICE PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 09/12/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: 3716292

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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