MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1518079532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518079532 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | BHRHC MTNCITY |
| Practice Address |
1901 S Shady St Mountain City TN 37683-2021 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 4237271103 |
| Practice Fax Number | 4237271140 |
| Mailing Telephone | 4237271103 |
| Mailing Fax Number | 4237271140 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-12-30 |
| 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0000000038 | TN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BHRHC MTNCITY | Doing Business As Name - Organization |
| Johnson County Medical Group | Doing Business As Name - Organization |
| MSMG FP IM MTN | 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 |
1901 S SHADY ST |
| City | MOUNTAIN CITY |
| State | TN |
| Zip Code | 37683-2021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194781724 | James W Shine | Family Medicine | 1901 S Shady St, Mountain City, TN 37683-2021 | 2006-04-22 |
| 1962020750 | Angela Harless | Registered Nurse | 1901 S Shady St, Mountain City, TN 37683-2021 | 2020-07-08 |
| 1316415706 | Sheila Ann Matherly | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683-2021 | 2018-11-05 |
| 1164999041 | Christina Nicole Morton | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683-2021 | 2018-10-29 |
| 1215431861 | Michelle Lee Manuel | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683-2021 | 2018-03-20 |
| 1801318126 | Nathan Robert Hitchcock | Registered Nurse | 1901 S Shady St, Mountain City, TN 37683-2021 | 2017-07-07 |
| 1366962631 | Lindsey Debord Yoggerst | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683-2021 | 2017-06-27 |
| 1184169658 | Wanda Jarrett | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683 | 2016-12-20 |
| 1548718752 | April Morrison | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683-2021 | 2016-09-16 |
| 1295142693 | Valley Ridge Emergency Physicians, LLP | Emergency Medicine | 1901 S Shady St, Mountain City, TN 37683-2021 | 2014-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245749126 | Sugaree Ganzman | Registered Nurse | 277 Trout Run Rd, Mountain City, TN 37683 | 2017-09-24 |
| 1013390764 | Emily B. Mcqueen | Nurse Practitioner | 1901 South Shady Street, Mountain City, TN 37683 | 2015-06-30 |
| 1972917755 | Kelly Horne Singleton | Nurse Practitioner | 3916 Hwy 421 South, Mountain City, TN 37683 | 2014-06-19 |
| 1548496557 | Michelle Wilson | Nurse Practitioner | 1901 S. Shady Street, Mountain City, TN 37683 | 2009-06-04 |
| 1710025069 | Sheila Annette Porter | Counselor | 318 Donnelly Street, Mtn City, TN 37683 | 2007-02-01 |
| 1619050390 | Brandy Lynn Bennett | Case Manager/Care Coordinator | 318 Donnelley Street, Johnson Co Counsel Cent, Mtn City, TN 37683 | 2006-10-24 |
| 1811086317 | Robb R Miller | Counselor | 318 Donnelley St, Johnson County Counseling Center, Mountain City, TN 37683 | 2006-10-12 |
| 1700834678 | Margaret Grace Steward | Pharmacist | 1641 South Shady St, Mountain City, TN 37683 | 2006-05-04 |
| 1558797399 | Mollie E Tolan | Nurse Practitioner | 1901 S. Shady Street, Johnson City, TN 37683 | 2013-09-25 |
| 1699014068 | Heather Newman | Family Medicine | 222 Oak St, Mountain City, TN 37683 | 2013-02-05 |
| Find all providers in zip 37683 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295779361 | East Tennessee State University | Clinic/Center | 1901 S Shady Street, Mountain City, TN 37683-2601 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275317 | Henry County Medical Center | Clinic/Center | 300 Hospital Cir Ste 204, Paris, TN 38242-4597 | 2020-08-14 |
| 1447861562 | Henry County Medical Center | Clinic/Center | 14201 Highway 79 N Unit 4, Buchanan, TN 38222-4183 | 2020-08-12 |
| 1003425224 | Dickson Medical Associate, PC | Clinic/Center | 127 Crestview Park Dr Ste 205, Dickson, TN 37055-2856 | 2020-07-23 |
| 1023631454 | Spring City Family Clinic Pllc | Clinic/Center | 126 Lavender St Ste 2, Spring City, TN 37381-5102 | 2020-05-20 |
| 1871001271 | Shelbyville Hospital Company LLC | Clinic/Center | 1330 Cedar Ln Ste 100, Tullahoma, TN 37388-2284 | 2018-01-19 |
| 1720596125 | Shelbyville Hospital Company LLC | Clinic/Center | 1440 Cedar Ln Unit 100, Tullahoma, TN 37388-2262 | 2018-01-19 |
| 1548788458 | Shelbyville Hospital Company LLC | Clinic/Center | 1612 N Main St Ste A, Shelbyville, TN 37160-2392 | 2017-08-31 |
| 1063938520 | Mid-south Convenient Care, Pllc | Clinic/Center | 1445 Us Highway 51 Byp E Ste B, Dyersburg, TN 38024-2127 | 2017-08-16 |
| 1871034462 | Martin Health | Clinic/Center | 143 Kennedy Drive, Martin, TN 38237-3309 | 2017-03-15 |
| 1881135895 | Humboldt Family Walk-in Clinic LLC | Clinic/Center | 1600 Coleman Dr, Humboldt, TN 38343-1756 | 2017-03-10 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN CITY |
| Zip Code | 37683 |
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.