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 1396049938

Blue Ridge Medical Management Corporation provides Pediatrics Physician services in Kingsport, Tennessee. Registered with an NPI since 2010.

In the registry since
2010

Practice location Address checks out

2204 Pavilion Dr Ste 210
Kingsport, TN 37660-4657 Not confirmed with CMS for 15 years — call before visiting
Phone: (423) 224-3933
Fax: (423) 224-3934
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 number1396049938
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carl Kilgore — President · (423) 915-5100
Other names Msmg Peds Kpt
NPI enumeratedDecember 22, 2010
Last updated in NPPESDecember 22, 2010
Mailing address2204 Pavilion Dr, Suite 210, Kingsport, TN 37660-4657

Other providers in Kingsport