MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1588853295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588853295 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | DBA MOUNTAIN STATES OUTPATIENT BEHAVIORAL HEALTH |
| Practice Address |
508 Princeton Commons Suite 403 Johnson City TN 37601-2060 |
| Practice Telephone | 4237223000 |
| Practice Fax Number | 4237223009 |
| Mailing Telephone | 4237223000 |
| Mailing Fax Number | 4237223009 |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-11-02 |
| Authorized Official Name | JEFFREY N DICE (ASSISTANT VICE PRESIDENT) |
| Authorized Official Telephone | 4234317060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| DBA Mountain States Outpatient Behavioral Health | 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 |
508 PRINCETON COMMONS SUITE 403 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228619 | Whidbey Island Public Hospital District | Psychiatry & Neurology | 1310 N Roan St, Johnson City, TN 37601-3942 | 2019-11-04 |
| 1942696158 | Bill Mccartt | Psychiatry & Neurology | 267 Laurel Cyn, Johnson City, TN 37615-4727 | 2015-04-14 |
| 1194146894 | Medical Education Assistance Corporation | Psychiatry & Neurology | 2109 W Market St Ste 140, Johnson City, TN 37604 | 2013-12-23 |
| 1538450408 | Faith A Aimua | Psychiatry & Neurology | 206 Princeton Rd Ste 18, Johnson City, TN 37601-2025 | 2011-04-27 |
| 1972753663 | Marina S.l. Colombo | Psychiatry & Neurology | Lamont and Veterans Way. Mountain Home., James H Quillen Va Med Center., Johnson City, TN 37684 | 2008-09-30 |
| 1639370950 | Marian Eleanor Steen | Psychiatry & Neurology | 607 E Watauga Ave Apt 3, Johnson City, TN 37601-4071 | 2007-05-31 |
| 1497967897 | David Lionel Forester | Psychiatry & Neurology | 209 E Unaka Ave, Johnson City, TN 37601-4625 | 2007-05-06 |
| 1407982762 | William Arthur Wiley Jr. | Psychiatry & Neurology | 112 E Myrtle Avenue, Suite 506, Johnson City, TN 37601-8600 | 2007-02-23 |
| 1356417661 | Jill Baron | Psychiatry & Neurology | 804 Valley Plaza, Johnson City, NY 13790 | 2006-11-28 |
| 1194829879 | James M. Turnbull | Psychiatry & Neurology | 111 West Tenth Avenue, Johnson City, TN 37604-3844 | 2006-09-12 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
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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.