BALLAD HEALTH MEDICAL ASSOCIATES
NPI 1568958775
Urology - Pediatric Urology in Johnson City, TN
About Ballad Health Medical Associates NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BALLAD HEALTH MEDICAL ASSOCIATES (NPI 1568958775) is a healthcare organization registered as a pediatric urology in Johnson City, Tennessee and active in the NPI registry since July 2018. The organization holds 2 active CLIA laboratory certificates and lists Carl Kilgore, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ballad Health Medical Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
493Medicare enrollment records show 493 clinicians reassign Medicare billing to Ballad Health Medical Associates, which bills Medicare for the services they deliver. Of these, 43 practice at this address and 190 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 39
Nearest to this location (20)
See all 493Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Johnson City, TN 37604
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 44D2114636
Msmg Pediatric Gastroenterology Dba Ballad Health Medical Associates · Johnson City, TNCertificate of Waiver 44D2101358
Msmg Pediatric Endocrinology Dba Ballad Health Medical Associates · Johnson City, TNFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Ridge Medical Management Corporation's NPI number?
The NPI number for Blue Ridge Medical Management Corporation is 1568958775. It was assigned to this organization in the NPPES registry on July 11, 2018. The provider is doing business as Ballad Health Medical Associates and MSMG Pediatric Urology Johnson City. The provider is also known as BHMA Pediatric Urology Johnson City.
Where is Blue Ridge Medical Management Corporation located?
Blue Ridge Medical Management Corporation is located at 408 N State Of Franklin Rd Ste 31F, Johnson City, TN 37604. The listed phone number is (423) 431-4946.
What is Blue Ridge Medical Management Corporation's specialty?
The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.
Is Blue Ridge Medical Management Corporation enrolled in Medicare?
Yes. Blue Ridge Medical Management Corporation is registered in the Medicare PECOS enrollment system.
When is Blue Ridge Medical Management Corporation's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Tennessee, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Blue Ridge Medical Management Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 493 clinicians in 39 Medicare specialties reassign their Medicare billing to Blue Ridge Medical Management Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (175), Internal Medicine (55) and Psychiatry (42). Of these, 43 practice at this address and 190 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Blue Ridge Medical Management Corporation hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Blue Ridge Medical Management Corporation was last updated on March 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ballad Health Medical Associates · NPI 1568958775
Pediatric Urology organization in Johnson City, Tennessee. Organization record, active in the CMS NPPES registry since July 11, 2018.
## Identity
- **NPI:** 1568958775 (Entity type: Organization)
- **Enumerated:** July 11, 2018
- **Primary specialty:** Urology - Pediatric Urology · taxonomy 2088P0231X
- **Legal business name:** Blue Ridge Medical Management Corporation
- **Also known as:** MSMG Pediatric Urology Johnson City (Doing Business As); BHMA Pediatric Urology Johnson City (Other Name)
- **Organization subpart:** No
- **Authorized official:** Carl Kilgore, PRESIDENT
## Practice location
- **Address:** 408 N STATE OF FRANKLIN RD STE 31F, Johnson City, TN 37604-6088
- **Phone:** (423) 431-4946 · **Fax:** (423) 431-4947
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Tennessee, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 493 clinicians in 39 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (175), Internal Medicine (55), Psychiatry (42); 43 practice at this address and 190 within 10 miles; [full list](https://npiprofile.com/npi/1568958775/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 29, 2019
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1568958775) · Data from the CMS NPPES public registry.