MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1205488996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205488996 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Practice Address |
127 Health Care Dr Pennington Gap VA 24277-2853 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 4234311941 |
| Practice Fax Number | 4234311244 |
| Mailing Telephone | 4234311941 |
| Mailing Fax Number | 4234311244 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals |
| Other Name | Type Code |
|---|---|
| Lee County Community 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 |
127 HEALTH CARE DR |
| City | PENNINGTON GAP |
| State | VA |
| Zip Code | 24277-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386689230 | Patrick A Molony | Internal Medicine | 127 Health Care Dr, Suite 8, Pennington Gap, VA 24277-2853 | 2006-06-17 |
| 1538668116 | Lee County Medical Center,llc | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2018-02-08 |
| 1942754858 | Stephanie Purvis | Nurse Practitioner | 127 Health Care Dr, Suite 8, Pennington Gap, VA 24277-2853 | 2016-08-09 |
| 1407252042 | Lee County Hospital Authority | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2014-11-10 |
| 1285916791 | Northeast Tennessee Emergency Physicians PC | Emergency Medicine | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2011-09-12 |
| 1215123971 | Fadi Ismail Abu-shahin | Internal Medicine | 127 Health Care Dr, Suite 9, Pennington Gap, VA 24277-2853 | 2007-09-17 |
| 1285827923 | Shahram Malik | Family Medicine | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2007-08-27 |
| 1376736637 | Wellmont Health System | Rehabilitation Unit | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2007-08-21 |
| 1962695254 | Wellmont Health System | Medicare Defined Swing Bed Unit | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2007-08-21 |
| 1598958886 | Wellmont Health System | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2007-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653686 | Tanya L Clark | Physical Therapist | 208 Health Care Drive, Pennington Gap, VA 24277 | 2018-09-15 |
| 1780066407 | Daniel Maurer | Psychologist | Lee County Industrial Park, Hickory Flats Road, Pennington Gap, VA 24277 | 2015-06-19 |
| 1952428864 | Valerie Renee Taylor | Physical Therapy Assistant | 1565 W. Morgan Ave, Pennington Gap, VA 24277 | 2007-03-23 |
| 1043358807 | Carolyn Sue Cope | Counselor | 430 Industrial Drive, Pennington Gap, VA 24277 | 2007-02-02 |
| 1417069725 | Angela Renee Mullins-russell | Counselor | 711 W Morgan Ave, Pennington Gap, VA 24277 | 2006-08-31 |
| 1548376403 | James Monroe Roberson Jr. | Dentist | 127 South Kentucky Street, Pennington Gap, VA 24277 | 2006-08-22 |
| 1053424721 | John C. Marion-pharmacist,p.c. | Pharmacist | 1724 Combs Road, Pennington Gap, VA 24277 | 2006-08-16 |
| 1134132319 | Hossein Faiz | Surgery | Lee Regional Medical Center 1800 Combs Rd, Medical Arts Plaza Suite 2, Pennington Gap, VA 24277 | 2006-08-15 |
| 1174564389 | Pennington Gap Hma Inc | Medicare Defined Swing Bed Unit | West Morgan Avenue, Pennington Gap, VA 24277 | 2006-06-09 |
| 1033159728 | Pennington Gap Hma Inc | General Acute Care Hospital | West Morgan Ave, Pennington Gap, VA 24277 | 2006-06-08 |
| Find all providers in zip 24277 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407252042 | Lee County Hospital Authority | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2014-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235316092 | Department of Veterans Affairs | General Acute Care Hospital | 13 S College Ave, Salem, VA 24153-3833 | 2008-01-23 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1902900202 | Pch Operations, LLC Dba R.j. Reynolds-patrick County Memorial Hospital | General Acute Care Hospital | 18688 Jeb Stuart Highway, Stuart, VA 24171 | 2006-09-08 |
| 1902807936 | Bath County Community Hospital | General Acute Care Hospital | 106 Park Drive, Hot Springs, VA 24445 | 2005-08-01 |
| 1205371549 | Bernardo Canga | General Acute Care Hospital | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2016-12-22 |
| 1699125526 | Chesapeake Hospital LLC | General Acute Care Hospital | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1740667229 | Norton Community Hospital | General Acute Care Hospital | 100 15th St Nw, Norton Community Hospital, Norton, VA 24273-1616 | 2015-05-04 |
| 1952792673 | Carilion Giles Community Hospital | General Acute Care Hospital | 159 Hartley Way, Pearisburg, VA 24134-2471 | 2015-02-17 |
| 1093094302 | University of Virginia | General Acute Care Hospital | 1215 Lee St, Charlottesville, VA 22908-0265 | 2011-08-04 |
| 1659513893 | Pioneer Health Services of Patrick County, Inc. | General Acute Care Hospital | 18688 Jeb Stuart Hwy, Stuart, VA 24171-1559 | 2009-04-02 |
| Find all providers with the same taxonomy | ||||
| City | PENNINGTON GAP |
| Zip Code | 24277 |
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.