OrganizationActive
Blue Ridge Medical Management Corporation
NPI 1568958775 · Pediatric Urology Physician · Johnson City, TN
Provider details
- NPI number
- 1568958775
- Entity type
- Organization
- Primary specialty
- Pediatric Urology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carl Kilgore, President(423) 302-3051
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
408 N State of Franklin Rd Ste 31f
Johnson City, TN 37604-6088
Phone: (423) 431-4946
Fax: (423) 431-4947
Street-level locationGet directions
Mailing address
408 N State of Franklin Rd Ste 31f
Johnson City, TN 37604-6088
Other names (DBA / former)
- Other name
- Bhma Pediatric Urology Johnson City
- Doing business as
- Ballad Health Medical Associates
- Doing business as
- Msmg Pediatric Urology Johnson City
Registry dates
- Enumerated
- 2018-07-11
- Last updated
- 2019-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.