MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1568649697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568649697 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | RUSSELL COUNTY PSYCHIATRIC UNIT |
| Practice Address |
58 Carroll St Lebanon VA 24266-4510 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 2768838000 |
| Practice Fax Number | 2768838250 |
| Mailing Telephone | 2768838000 |
| Mailing Fax Number | 2768838250 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2018-03-29 |
| 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 | 273R00000X | Psychiatric Unit | H1892 | VA | Hospital Units |
| Other Name | Type Code |
|---|---|
| Russell County Psychiatric Unit | 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 |
58 CARROLL ST |
| City | LEBANON |
| State | VA |
| Zip Code | 24266-4510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962401448 | John Martin Kerr | Surgery | 58 Carroll St, Suite 2d, Lebanon, VA 24266 | 2005-07-18 |
| 1306376108 | Sasha Musick | Nurse Practitioner | 58 Carroll St, Room 2037, Lebanon, VA 24266 | 2017-06-14 |
| 1073990248 | Blue Ridge Medical Managment Corporation | Internal Medicine | 58 Carroll St, Room 2037, Lebanon, VA 24266 | 2015-04-27 |
| 1053719450 | Tara Dalton | Pharmacist | 58 Carroll St, Lebanon, VA 24266 | 2014-12-17 |
| 1841694486 | Amanda Hansen | Nurse Practitioner | 58 Carroll St, Room 2037, Lebanon, VA 24266 | 2014-10-10 |
| 1104158054 | Mountain States Health Alliance | Radiology | 58 Carroll St, Lebanon, VA 24266-3600 | 2010-02-03 |
| 1891973939 | Mountain States Health Alliance | General Acute Care Hospital | 58 Carroll St, Lebanon, VA 24266-4515 | 2008-01-31 |
| 1861670903 | Mountain States Health Alliance | Medicare Defined Swing Bed Unit | 58 Carroll St, Lebanon, VA 24266-4510 | 2008-01-31 |
| 1528249133 | Jenny M Pruitt | Physician Assistant | 58 Carroll St, Room 2037, Lebanon, VA 24266 | 2007-11-26 |
| 1699724013 | David M Mitchell | Internal Medicine | 58 Carroll St, Room 2037, Lebanon, VA 24266 | 2006-05-10 |
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| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821030842 | Vanderbilt University Medical Center | Psychiatric Unit | 500 Park Avenue, Lebanon, TN 37087-3721 | 2006-06-12 |
| 1477117273 | Vanderbilt University Medical Center | Psychiatric Unit | 500 Park Ave, Lebanon, TN 37087-3721 | 2019-04-26 |
| 1215390513 | Spring View Hospital LLC | Psychiatric Unit | 320 N Loretto Rd, Lebanon, KY 40033-1300 | 2016-04-04 |
| 1619019791 | Witham Memorial Hospital | Psychiatric Unit | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2007-02-13 |
| 1023092053 | Mary Hitchcock Memorial Hospital | Psychiatric Unit | One Medical Center Dr, Lebanon, NH 03756-0001 | 2005-12-02 |
| 1871599308 | Russell County Medical Center, Inc | Psychiatric Unit | 58 Carroll Street, Lebanon, VA 24266 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326594524 | Virginia Commonwealth University Health System | Psychiatric Unit | 1300 E. Marshall Street, Suite 275 3rd F, Richmond, VA 23298 | 2016-08-28 |
| 1528005691 | Lewis-gale Medical Center, LLC | Psychiatric Unit | 1902 Braeburn Dr, Salem, VA 24153-7304 | 2006-05-31 |
| 1922004530 | Chesapeake Hospital Corporation | Psychiatric Unit | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2005-06-28 |
| 1467097535 | Bon Secours Mercy Health Emporia LLC | Psychiatric Unit | 727 N Main St, Emporia, VA 23847-1274 | 2019-11-13 |
| 1477018893 | Pulaski Community Hospital, Inc. | Psychiatric Unit | 2400 Lee Hwy N, Pulaski, VA 24301-2326 | 2019-02-11 |
| 1790135622 | Chesapeake Hospital LLC | Psychiatric Unit | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1902274681 | Southwestern Virginia Mental Health Institute | Psychiatric Unit | 340 Bagley Cir, Marion, VA 24354-3126 | 2015-09-11 |
| 1164815544 | Chippenham & Johnston-willis Hospitals, Inc. | Psychiatric Unit | 7101 Jahnke Rd, Richmond, VA 23225-4017 | 2015-03-10 |
| 1790178176 | Columbia/hca John Randolph, Inc. | Psychiatric Unit | 411 W Randolph Rd, Hopewell, VA 23860-2938 | 2015-03-10 |
| 1609269083 | Lewis-gale Medical Center, LLC | Psychiatric Unit | 1902 Braeburn Dr, Salem, VA 24153-7304 | 2015-03-10 |
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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.