MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1073064333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073064333 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Practice Address |
400 N St of Franklin Rd Johnson City TN 37604 |
| Mailing Address |
400 N State of Franklin Rd Johnson City TN 37604-6035 |
| Practice Telephone | 4234315339 |
| Mailing Telephone | 4234315339 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | SANDRA CASTRO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4234315339 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC2000X |
General Acute Care Hospital Specialization: Children |
21920 | TN | Hospitals |
| 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 |
| 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 |
400 N ST OF FRANKLIN RD |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604 |
| 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 | 282NC2000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Children |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003211145 | Monroe Carell Jr. Children's Hospital At Vanderbilt | General Acute Care Hospital | 2200 Childrens Way Preston Research Bldg 395, Nashville, TN 37232-0005 | 2014-10-31 |
| 1609056399 | Vanderbilt Children's | General Acute Care Hospital | 1702 The Vanderbilt Clinic, 1301 22nd Ave South, Nashville, TN 37232-0001 | 2007-11-09 |
| 1275023095 | Baptist Memorial Hospital | General Acute Care Hospital | 6225 Humphreys Blvd, Memphis, TN 38120-2373 | 2018-05-17 |
| 1154861219 | Ut Medical Group, Inc. | General Acute Care Hospital | 51 N Dunlap St, Neonatal Intensive Care Unit, Memphis, TN 38105-4625 | 2017-03-08 |
| 1902261860 | Vanderbilt University Medical Center | General Acute Care Hospital | 1211 Medical Center Dr, Nashville, TN 37232-0004 | 2015-12-20 |
| 1881078962 | Vanderbilt University | General Acute Care Hospital | 2200 Childrens Way, Nashville, TN 37232-0005 | 2015-07-17 |
| 1649654450 | Methodist Healthcare - Memphis Hospitals | General Acute Care Hospital | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2015-07-13 |
| 1003238759 | Lauren Braun | General Acute Care Hospital | 1211 21st Ave S, Medical Arts 607, Nashville, TN 37232-2717 | 2014-01-15 |
| 1861814634 | Katherine Fay Kines | General Acute Care Hospital | 1211 21st Ave S, 607 Medical Arts Building, Nashville, TN 37232-1030 | 2014-01-14 |
| 1144663642 | University of Tennessee Memphis Pediatrics | General Acute Care Hospital | 50 N Dunlap St, Memphis, TN 38103-2800 | 2013-04-15 |
| Find all providers with the same taxonomy | ||||
| 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.