Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Blue Ridge Medical Management Corporation

Organization Pediatrics Physician · NPI 1295903565

Blue Ridge Medical Management Corporation provides Pediatrics Physician services in Lebanon, Virginia. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

344 Overlook Dr
Lebanon, VA 24266-3436 Not confirmed with CMS for 15 years — call before visiting
Phone: (276) 889-0201
Fax: (276) 889-0081
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1295903565
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carl Kilgore — President · (423) 915-5116
Other names Msmg Peds Leb
NPI enumeratedFebruary 20, 2008
Last updated in NPPESOctober 29, 2010
Mailing addressPo Box 3700, Johnson City, TN 37602-3700

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