MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1124139464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124139464 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | JOHNSON CITY MEDICAL CENTER SKILLED NURSING FACILITY |
| Practice Address |
2511 Wesley St Johnson City TN 37601-1723 |
| Practice Telephone | 4239521700 |
| Practice Fax Number | 4239523398 |
| Mailing Telephone | 4239521700 |
| Mailing Fax Number | 4239523398 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARVIN H EICHORN (SVP/CFO) |
| Authorized Official Telephone | 4234316111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0000000329 | TN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Johnson City Medical Center Skilled Nursing Facility | 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 |
2511 WESLEY ST |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-1723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083671929 | Michael L Spady | Physical Medicine & Rehabilitation | 2511 Wesley St, Johnson City, TN 37601-1723 | 2006-04-26 |
| 1609287937 | Quillen Rehabilitation Hospital of Johnson City LLC | Rehabilitation Hospital | 2511 Wesley St, Johnson City, TN 37601-1723 | 2014-05-08 |
| 1548568082 | Mountain States Health Alliance | Skilled Nursing Facility | 2511 Wesley St, Johnson City, TN 37601-1723 | 2011-03-08 |
| 1154588747 | Elaine L Devos | Physical Medicine & Rehabilitation | 2511 Wesley St, Johnson City, TN 37601-1723 | 2008-05-21 |
| 1821263906 | Elaine L. Devos Md PC | Rehabilitation Practitioner | 2511 Wesley St, Johnson City, TN 37601-1723 | 2008-04-29 |
| 1063605491 | Franklin Rehab Clinic | Physical Medicine & Rehabilitation | 2511 Wesley St, Johnson City, TN 37601-1723 | 2007-08-20 |
| 1043400583 | Cara Estep | Occupational Therapist | 2511 Wesley St, Johnson City, TN 37601-1723 | 2007-07-31 |
| 1609984954 | Mountain States Health Alliance | Rehabilitation Unit | 2511 Wesley St, Johnson City, TN 37601-1723 | 2006-08-28 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1932262334 | Asbury, Inc. | Skilled Nursing Facility | 105 W Myrtle Ave, Johnson City, TN 37604-5633 | 2006-12-18 |
| 1366472052 | Umh Jgj Corp | Skilled Nursing Facility | 286 Deyo Hill Rd, Johnson City, NY 13790-5110 | 2006-07-05 |
| 1699711192 | Nhc Healthcare-johnson City LLC | Skilled Nursing Facility | 3209 Bristol Hwy, Johnson City, TN 37601-1515 | 2006-06-22 |
| 1245216910 | Management Care Corporation | Skilled Nursing Facility | 115 Woodlawn Dr, Johnson City, TN 37604-5978 | 2005-12-15 |
| 1285615682 | Susquehanna Nursing & Rehabilitation Center, LLC | Skilled Nursing Facility | 282 Riverside Dr, Johnson City, NY 13790-2727 | 2005-11-11 |
| 1043763592 | Lakebridge A Waters Community LLC | Skilled Nursing Facility | 115 Woodlawn Dr, Johnson City, TN 37604-5978 | 2016-08-02 |
| 1841743291 | The Waters of Johnson City LLC | Skilled Nursing Facility | 140 Technology Ln, Johnson City, TN 37604-2004 | 2016-08-02 |
| 1366835209 | Caregivers | Skilled Nursing Facility | 260 Harry L Dr, Johnson City, NY 13790-1493 | 2015-03-17 |
| 1548568082 | Mountain States Health Alliance | Skilled Nursing Facility | 2511 Wesley St, Johnson City, TN 37601-1723 | 2011-03-08 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
Please comment or provide details below to improve the information on MOUNTAIN STATES HEALTH ALLIANCE.
| 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.