MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1245781954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245781954 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | MSMG RURAL HEALTH CLIINIC LEBANON |
| Practice Address |
58 Carroll St Suite 3 Dept of Russell County Medical Center Lebanon VA 24266 |
| Practice Telephone | 2768838340 |
| Practice Fax Number | 2768838341 |
| Mailing Telephone | 2768838340 |
| Mailing Fax Number | 2768838341 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | CARL KILGORE (PRESIDENT) |
| Authorized Official Telephone | 4239155185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | DEPARTMENT OF LABOR | 020157701 | 01 |
| VA | 1245781954 | 05 |
| Other Name | Type Code |
|---|---|
| MSMG Lebanon Family Practice | Doing Business As Name - Organization |
| MSMG Rural Health Cliinic Lebanon | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 71 S Flannagan Ave, Lebanon, VA 24266 | 2768838042 | 2768838044 |
| 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 |
| 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 |
| 1144408279 | Mountain States Health Alliance | Hospice Care, Community Based | 75 S Flannagan Ave, Lebanon, VA 24266 | 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 |
58 CARROLL ST SUITE 3 DEPT OF RUSSELL COUNTY MEDICAL CENTER |
| City | LEBANON |
| State | VA |
| Zip Code | 24266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1962051763 | Best Life Physical Therapy Inc. | Physical Therapist | 383 Technology Park Drive, Lebanon, VA 24266 | 2019-09-05 |
| 1093361024 | Alexis Rae Carson | Psychologist | 84 Dr Lorraine C. Turner Dr. Russell County Public Scho, Lebanon, VA 24266 | 2019-08-15 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1659883312 | Sara K Poole | Occupational Therapist | 408 Fields Ave., Lebanon, VA 24266 | 2017-11-02 |
| Find all providers in zip 24266 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538636311 | One Cross Health Clinic, Inc. | Clinic/Center | 305 Koehler Drive, Lebanon, KY 40033 | 2018-10-30 |
| 1508122763 | Mid-valley Healthcare, Inc. | Clinic/Center | 35 Mullins Drive, Suite 2, Lebanon, OR 97355 | 2012-04-02 |
| 1235204405 | Elissa Whittenburg Md Pa | Clinic/Center | 1237 Fox Hollow Dr, Lebanon, OH 45036-7846 | 2006-11-22 |
| 1891885273 | Family Health Care Associates | Clinic/Center | 143 West Main Street, Lebanon, VA 24266-4214 | 2006-10-13 |
| 1770675035 | Lester E Cox Medical Centers | Clinic/Center | 510 E Hwy 32, Lebanon, MO 65536 | 2006-09-28 |
| 1225093479 | Merit Medical Rhc Lebanon Inc | Clinic/Center | 360 West Main Street, Lebanon, VA 24266 | 2006-04-19 |
| 1245772664 | Mountain States Health Alliance | Clinic/Center | 71 S Flannagan Ave, Lebanon, VA 24266-3600 | 2016-11-16 |
| 1578901773 | Mercy Hospital Lebanon | Clinic/Center | 120 Hospital Dr, Suite 225, Lebanon, MO 65536-9238 | 2013-06-10 |
| 1558709071 | Mercy Hospital Lebanon | Clinic/Center | 331 Hospital Dr, Suite C, Lebanon, MO 65536-9217 | 2013-06-06 |
| 1366880874 | Mercy Hospital Lebanon | Clinic/Center | 120 Hospital Dr, Suite 100, Lebanon, MO 65536-9238 | 2013-06-06 |
| Find all providers in LEBANON | ||||
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.