CMS-1500 Box 24J / 33a • NPI
1639463490
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208M00000X (CMS C6)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist
Box 32 Service Location & ZIP+4
245 MEDICAL PARK DR, FIRST FLOOR, MARION, VA, 24354-1100
✓ 9-Digit EDI 837 ZIP+4 (24354-1100)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639463490 (BLUE RIDGE MEDICAL MANAGEMENT CORPORATION) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1639463490 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist NUCC Code: 208M00000X (Hospitalist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 245 MEDICAL PARK DR, FIRST FLOOR, MARION, VA, 24354-1100 |
| Practice Telephone / Fax | Tel: (276) 378-1341 | Fax: (276) 378-1205 |
| Administrative Mailing Address | 245 MEDICAL PARK DR, MARION, VA, 24354-1100 |
| Enumeration & Last Sync | Enumerated: 2011-06-08 | CMS Record Updated: 2019-03-29 |
| Authorized Official | CARL KILGORE (PRESIDENT) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208M00000X)
What Does Taxonomy Code 208M00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208M00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BLUE RIDGE MEDICAL MANAGEMENT CORPORATION)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: N/A | License: Verified | Primary: Secondary |
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: N/A | License: Verified | Primary: Secondary |
208M00000X — HospitalistPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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