MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1023129376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023129376 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | JOHNSON CITY SPECIALTY HOSPITAL |
| Practice Address |
203 E Watauga Ave Johnson City TN 37601-4629 |
| Practice Telephone | 4239261111 |
| Practice Fax Number | 4239796163 |
| Mailing Telephone | 4239261111 |
| Mailing Fax Number | 4239796163 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | MARVIN H EICHORN (SVP/CFO) |
| Authorized Official Telephone | 4234316111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 0000000122 | TN | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0440105 | 05 | |
| CIGNA | 0700245 | 01 | |
| VA | 004401051 | 05 | |
| BLUE CROSS | 1000373 | 01 | |
| ANTHEM | 437727 | 01 | |
| KY | 01600964 | 05 | |
| PHP | 100020074 | 01 | |
| JOHN DEERE | A3760124 | 01 | |
| FL | 091618800 | 05 | |
| NC | 4400105 | 05 |
| Other Name | Type Code |
|---|---|
| Johnson City Specialty Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962998732 | Mountain States Health Alliance | Home Health | 312 Cummings St Ste A, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1336635192 | Mountain States Health Alliance | Hospice, Inpatient | 312 Cummings St Ste B, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1669902243 | Mountain States Health Alliance | Hospice Care, Community Based | 312 Hospital Dr Suite 1b, Clintwood, VA 24228 | 2017-06-15 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1073064333 | Mountain States Health Alliance | General Acute Care Hospital | 400 N St of Franklin Rd, Johnson City, TN 37604 | 2016-10-20 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1316322555 | Mountain States Health Alliance | General Acute Care Hospital | 81 S Flanagan Avenue, Lebanon, VA 24266-4515 | 2015-07-29 |
| 1619357928 | Mountain States Health Alliance | General Acute Care Hospital | 111 S Flannagan Avenue, Lebanon, VA 24266-4515 | 2015-06-02 |
| 1700054095 | Mountain States Health Alliance | Psychiatry & Neurology | 58 Carroll Steet, Lebanon, VA 24266 | 2008-02-20 |
| 1609054733 | Mountain States Health Alliance | Clinic/Center | 16431 Wise Street, Saint Paul, VA 24283-3537 | 2008-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Mountain States Health Alliance | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Virginia Business Entities | Mountain States Health Alliance | 400 N State of Franklin Rd, Johnson City, Tennessee 37604 |
| Street Address |
203 E WATAUGA AVE |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-4629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760487946 | Frederick C Hartley | Obstetrics & Gynecology | 203 E Watauga Ave, Johnson City, TN 37601-4629 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427201813 | Va Medical Center Mountain Home, Tn | General Acute Care Hospital | 1st Street Bldg 204, James H. Quillen Va Medical Center Emergency Dept, Johnson City, TN 37684-4000 | 2008-10-29 |
| 1982779310 | Dr Charles J Badger II, General Practioner, PC | General Acute Care Hospital | 156 Corliss Ave Apt 708, Johnson City, NY 13790-2071 | 2006-11-21 |
| 1114033628 | Mountain States Health Alliance | General Acute Care Hospital | 300 Med Tech Pkwy, Johnson City, TN 37604-2277 | 2006-08-21 |
| 1194267765 | Brett Lane Reece | General Acute Care Hospital | 300 Med Tech Pkwy, Johnson City, TN 37604-2277 | 2016-11-13 |
| 1144605346 | Johnson City Medical Center | General Acute Care Hospital | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2015-07-29 |
| 1093943565 | United Health Services Hospital | General Acute Care Hospital | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2009-06-23 |
| 1992869556 | Mountain States Health Alliance Indian Path Medical Center | General Acute Care Hospital | 400 N State of Franklin Rd, Managed Care Administration, Johnson City, TN 37604-6035 | 2006-12-20 |
| 1366506925 | Mountain States Health Alliance Sycamore Shoals Hospital | General Acute Care Hospital | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2006-12-20 |
| 1184788945 | Mountain States Health Alliance Indian Path Medical Center | General Acute Care Hospital | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174033906 | Behavioral Health of Rocky Top, LLC | General Acute Care Hospital | 210 Industrial Park Dr, Rocky Top, TN 37769-2301 | 2017-10-06 |
| 1104290667 | Michelle Mcconnell Spradley | General Acute Care Hospital | 5006 Dell Dr, Mount Juliet, TN 37122-4157 | 2015-11-20 |
| 1215301981 | Cheryl Hall Wideman | General Acute Care Hospital | 3721 Russell Hurst Dr E, Bartlett, TN 38135-1965 | 2015-11-18 |
| 1104206135 | Vanderbilt University | General Acute Care Hospital | 62 Parks Ln, Fayetteville, TN 37334-6642 | 2015-06-04 |
| 1306247515 | Fort Sanders Regional Medical Center | General Acute Care Hospital | 614 Emory Oak Ct, Knoxville, TN 37909-3439 | 2014-09-07 |
| 1740609130 | Select Specialty | General Acute Care Hospital | 2000 Hayes St Ste 1502, Nashville, TN 37203-2318 | 2014-04-14 |
| 1710301320 | Veronica Blackman | General Acute Care Hospital | 447 Shelley Renee Ln, Cordova, TN 38018-4310 | 2014-02-18 |
| 1962826107 | Hoke Steven Fitzgerald | General Acute Care Hospital | 1073 Smithfield Rd, Tellico Plains, TN 37385-6137 | 2014-02-07 |
| 1336560598 | Vanderbilt University Medical Center | General Acute Care Hospital | 607 Medical Arts Building, 1121 21st Avenue South, Nashville, TN 37232-1320 | 2013-12-13 |
| 1710314554 | Centennial | General Acute Care Hospital | 552 Metroplex Dr, Nashville, TN 37211-3133 | 2013-10-10 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
Please comment or provide details below to improve the information on MOUNTAIN STATES HEALTH ALLIANCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.