MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1104158054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104158054 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | RCMC NIGHTHAWK READINGS |
| Practice Address |
58 Carroll St Lebanon VA 24266-3600 |
| Mailing Address |
Po Box 3600 Lebanon VA 24266-0200 |
| Practice Telephone | 2768838101 |
| Mailing Telephone | 2768838101 |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |
| Authorized Official Name | EDDIE C GREENE (AVP/ADMINISTRATOR) |
| Authorized Official Telephone | 2468838101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| RCMC Nighthawk Readings | 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 | 24266-3600 |
| 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 |
| 1891973939 | Mountain States Health Alliance | General Acute Care Hospital | 58 Carroll St, Lebanon, VA 24266-4515 | 2008-01-31 |
| 1568649697 | Mountain States Health Alliance | Psychiatric Unit | 58 Carroll St, Lebanon, VA 24266-4510 | 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551132 | Lebanon Pet Scan Center, LLC | Radiology | 103 Physicians Way Ste 100, Lebanon, TN 37090-4129 | 2020-02-28 |
| 1417319161 | Joseph Martin Clark | Radiology | 16 E High St, Lebanon, PA 17042-5454 | 2016-03-22 |
| 1902900061 | Susan B Humphreys Md PC | Radiology | Carroll & Tate Streets, Lebanon, VA 24266 | 2006-09-11 |
| 1467499079 | Philip Dennison Stieg | Radiology | Fourth & Walnut Streets, Radiology Department, Lebanon, PA 17042-1281 | 2006-06-01 |
| 1285689513 | Vision Imaging of Lebanon LLC | Radiology | 805 Helen Dr, Lebanon, PA 17042-7493 | 2006-05-24 |
| 1902876352 | Radiology & Nuclear Medicine Associates | Radiology | 1411 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-01-26 |
| 1669469532 | Daniel William Hottenstein | Radiology | 231 Valley Rd, Lebanon, PA 17042-8930 | 2005-10-05 |
| 1811998073 | Susan Barrow Humphreys | Radiology | Carroll & Tate Sts, Box 3600, Lebanon, VA 24266 | 2005-08-09 |
| 1346246436 | Lebanon Diagnostic Imaging, LLC | Radiology | 960 Isabel Dr, Lebanon, PA 17042-7482 | 2005-06-23 |
| 1386175859 | Joshua Harris Litchman | Radiology | 1 Medical Dr, Lebanon, NH 03756 | 2017-03-25 |
| Find all providers in LEBANON | ||||
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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.