MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1336635192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336635192 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | BALLAD HEALTH HOSPICE |
| Practice Address |
312 Cummings St Ste B Abingdon VA 24210-3200 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 2766194500 |
| Practice Fax Number | 4238446379 |
| Mailing Telephone | 2766194500 |
| Mailing Fax Number | 4238446379 |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2019-02-25 |
| 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 | 315D00000X | Hospice, Inpatient | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Ballad Health Hospice | 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 |
| 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 |
| 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 |
312 CUMMINGS ST STE B |
| City | ABINGDON |
| State | VA |
| Zip Code | 24210-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184192890 | Clinton Samuel Steve Webb | Nurse Practitioner | 406 W Main St Ste 100, Abingdon, VA 24210 | 2018-11-12 |
| 1528565801 | Crossroads Treatment Center of Petersburg, PC | Clinic/Center | 301 Falls Dr Nw Ste 353, Abingdon, VA 24210 | 2018-04-12 |
| 1780189035 | Vickie Lynne Beam | Speech-Language Pathologist | Washington County Public Schools, 812 Thompson Drive, Abingdon, VA 24210 | 2018-03-28 |
| 1093235814 | Meagan R Compton | Speech-Language Pathologist | 18596 Lee Hwy Suite B, Abingdon, VA 24210 | 2017-06-22 |
| 1710433404 | Highlands Community Pharmacy Inc | Pharmacy | 16400 Jeb Stuart Highway, Abingdon, VA 24210 | 2016-09-01 |
| 1548632417 | Lauren Irene Esposito | Audiologist | 319 Falls Drive, Abingdon, VA 24210 | 2015-10-30 |
| 1073909784 | Michael Justice | Pharmacist | 1 Food City Circle, Abingdon, VA 24210 | 2015-04-09 |
| 1245574177 | Watauga Medical Group | Family Medicine | 300 Valley St, Ne, Abingdon, VA 24210 | 2012-11-15 |
| 1083908883 | Kimberly Regina Mullins | Occupational Therapy Assistant | 17575 Havens Rest Rd., Abingdon, VA 24210 | 2011-06-09 |
| 1902131170 | Sara Jeannette Creekmore | Family Medicine | 328-a Cummings St., Abingdon, VA 24210 | 2009-10-06 |
| Find all providers in zip 24210 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871507426 | Wellmont Health System | Hospice, Inpatient | 988 W Main St, Abingdon, VA 24210 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073989836 | Bartee's Consultation Services | Hospice, Inpatient | 6615 W James Anderson Hwy, Gladstone, VA 24553-3518 | 2015-08-17 |
| 1205133089 | Life Cycle Services Inc. | Hospice, Inpatient | 904 Audubon Cir, Chesapeake, VA 23320-0663 | 2011-02-14 |
| 1831418656 | Angel Nursing Homecare, Inc. | Hospice, Inpatient | 9508 Claychin Ct, Burke, VA 22015-4187 | 2010-05-18 |
| 1194787226 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Hospice, Inpatient | 8580 Magellan Pkwy, Bldg Iv, Richmond, VA 23227-1149 | 2006-04-04 |
| 1154568954 | Bath County Community Hospital | Hospice, Inpatient | 106 Park Drive, Hot Springs, VA 24445 | 2009-01-15 |
| 1568485894 | Capital Hospice | Hospice, Inpatient | 2900 Telestar Ct, Falls Church, VA 22042-1206 | 2006-07-26 |
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| 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.