MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1649578386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649578386 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | JOHNSON CITY MEDICAL CENTER, REGIONAL CANCER CENTER |
| Practice Address |
1 Professional Park Dr Suite 21 Room C-17 Johnson City TN 37604-6587 |
| Practice Telephone | 4232326900 |
| Practice Fax Number | 4232326903 |
| Mailing Telephone | 4232326900 |
| Mailing Fax Number | 4232326903 |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-03-04 |
| Authorized Official Name | GRACIELA PEREIRA (AVP) |
| Authorized Official Telephone | 4234317060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Johnson City Medical Center, Regional Cancer Center | 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 |
1 PROFESSIONAL PARK DR SUITE 21 ROOM C-17 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376548677 | Nancy G. Barbarito | Family Medicine | 1 Professional Park Dr, Ste 21, Johnson City, TN 37604-6589 | 2005-06-15 |
| 1063822773 | Julia E Davenport | Nurse Practitioner | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2014-05-02 |
| 1174957864 | Kevin K Blake | Registered Nurse | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2013-08-29 |
| 1194040493 | Elnora Spradling | Internal Medicine | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2010-03-30 |
| 1275761538 | Blue Ridge Medical Management Corporation | Internal Medicine | 1 Professional Park Dr, Ste 21, Johnson City, TN 37604-6587 | 2009-06-25 |
| 1164677647 | Kimberly Michelle Arrowood | Nurse Practitioner | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2008-11-25 |
| 1992993760 | Kanishka Chakraborty | Internal Medicine | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2007-10-05 |
| 1326178138 | Melanie R. Harrison | Emergency Medicine | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2007-03-07 |
| 1619039948 | Mary Ann Cash | Nurse Practitioner | 1 Professional Park Dr, Suite 18, Johnson City, TN 37604-6587 | 2006-12-14 |
| 1144241464 | Koyamangalath Krishnan | Internal Medicine | 1 Professional Park Dr, Ste 21, Johnson City, TN 37604-6587 | 2006-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699256628 | Beth Evelyn Barber | Social Worker | 911 Millercrest Dr, Johnson City, TN 37604-4331 | 2018-08-27 |
| 1902258239 | Amber Street | Social Worker | 403 Princeton Rd Ste 2, Johnson City, TN 37601-2040 | 2016-07-11 |
| 1760833164 | Derek Shea Bowers | Social Worker | 207 N Boone St Ste 13, Johnson City, TN 37604-5659 | 2016-06-27 |
| 1952737785 | Carolyn Elaine Conerly | Social Worker | 1185 W Mountain View Rd, 2209, Johnson City, TN 37604-2523 | 2013-09-25 |
| 1265796072 | Peace of Mind Therapy Services | Social Worker | 207 Boone St, Suite 27, Johnson City, TN 37604-5603 | 2012-06-26 |
| 1326347311 | Jonathan Lynn Hartsell | Social Worker | 207 Boone Street, Suite 27, Johnson City, TN 37604 | 2011-03-16 |
| 1174838932 | Janie Allene Short | Social Worker | 306 W Holston Ave, Johnson City, TN 37604-5526 | 2010-08-17 |
| 1124254990 | Marylyn Beeson Bowman | Social Worker | 169 E Grand Ave, Apt 101, Johnson City, TN 37601-5609 | 2009-06-06 |
| 1336312685 | Lydia Pipes Roane | Social Worker | 703 Hiwassee Hill Dr, Johnson City, TN 37601-7603 | 2008-04-08 |
| 1295954543 | Sharon L Moss | Social Worker | 175 Wyok Rd, Johnson City, NY 13790-4223 | 2007-04-25 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.