BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
NPI 1659475374
Psychiatry & Neurology - Addiction Medicine in Kingsport, TN

Q: What is Blue Ridge Medical Management Corporation's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Medicine, with taxonomy code 2084A0401X.

Active since September 12, 2006

2300 PAVILION DR, KINGSPORT, TN 37660(423) 392-5500(423) 392-5597 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Blue Ridge Medical Management Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (NPI 1659475374), doing business as Dba Indian Path Pavilion, is a healthcare organization registered as an addiction medicine in Kingsport, Tennessee and active in the NPI registry since September 2006. The organization lists C. Steven Kilgore, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1659475374

Entity TypeOrganization

Primary Taxonomy2084A0401X

Legal Business NameBLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Location Address2300 PAVILION DRKingsport, TN 37660-4622

Mailing Address2300 Pavilion DrKingsport, TN 37660-4622 · (423) 392-5500 · Fax (423) 392-5597

Phone(423) 392-5500

Fax(423) 392-5597

Organization SubpartNo

Authorized OfficialC. Steven KilgoreSenior Vice President · (423) 915-5185

Enumeration DateSeptember 12, 2006

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1659475374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084A0401X

Definition

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

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

2300 PAVILION DR, Kingsport, TN 37660

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Other Names 1

Doing Business AsDba Indian Path Pavilion

Other Identifiers 1

Medicaid3716292TN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDEN GALVEZ

Physical Therapy Assistant