MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1306036041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306036041 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | MOUNTAIN STATES LIFELINE |
| Practice Address |
1021 W Oakland Ave Suite 310 Johnson City TN 37604-2191 |
| Practice Telephone | 4239523732 |
| Practice Fax Number | 4239523750 |
| Mailing Telephone | 4239523732 |
| Mailing Fax Number | 4239523750 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |
| 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 | 146D00000X | Personal Emergency Response Attendant | Emergency Medical Service Providers |
| Other Name | Type Code |
|---|---|
| Mountain States Lifeline | 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 |
1021 W OAKLAND AVE SUITE 310 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639160815 | James Richard Risney | Dermatology | 1021 W Oakland Ave, Suite 102, Johnson City, TN 37604-2191 | 2005-11-04 |
| 1508231572 | Appalachian Emergency Physicians | Emergency Medicine | 1021 W Oakland Ave, Suite 201, Johnson City, TN 37604-2191 | 2015-12-02 |
| 1013314384 | Samantha Manuel I | Nurse Practitioner | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2014-12-02 |
| 1386902971 | Douglas Edema | Family Medicine | 1021 W Oakland Ave, Suite 207, Johnson City, TN 37604-2191 | 2012-05-02 |
| 1720269731 | Nerissa Licup | Internal Medicine | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2007-11-19 |
| 1336335835 | Ambreen Adil Warsy | Family Medicine | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2007-09-18 |
| 1427163666 | The Regional Center for Oral & Maxillofacial Surgery, PC | Dentist | 1021 W Oakland Ave, Suite 109, Johnson City, TN 37604-2191 | 2006-08-20 |
| 1255341509 | Blue Ridge Medical Management Corporation | Nursing Facility/Intermediate Care Facility | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2006-08-09 |
| 1124043120 | Jeremy Nathan Elliott | Family Medicine | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2006-07-12 |
| 1497719322 | Brittany M Cantrell | Physician Assistant | 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 | 2006-04-17 |
| 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 | 146D00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Personal Emergency Response Attendant |
| Individuals that are specially trained to assist patients living at home with urgent/emergent situations. These individuals must be able to perform CPR and basic first aid and have sufficient counseling skills to allay fears and assist in working through processes necessary to resolve the crisis. Functions may include transportation to various facilities and businesses, contacting agencies to initiate remediation service or providing reassurance. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043485378 | Isaac Lee Martin Jr. | Personal Emergency Response Attendant | 109 W Watauga Ave, Johnson City, TN 37604-5621 | 2008-04-28 |
| 1467577684 | Brandy Michelle Garland | Personal Emergency Response Attendant | 109 W Watauga Ave, Johnson City, TN 37604-5621 | 2007-03-20 |
| 1982729638 | Alisa F Nunley | Personal Emergency Response Attendant | 109 W Watauga Ave, Johnson City, TN 37604-5621 | 2007-03-20 |
| 1154469054 | Mary Erney Lamoy | Personal Emergency Response Attendant | 109 W Watauga Ave, Johnson City, TN 37604 | 2007-02-02 |
| 1609959287 | Robert William Dugger | Personal Emergency Response Attendant | 109 W Watauga Ave, Johnson City, TN 37601 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063659209 | Songmin Cai | Personal Emergency Response Attendant | 10 Knolls Pl, Knolls Place Medical Cilinc, Nashville, TN 37211-7410 | 2009-01-09 |
| 1972647253 | Guardian Angel Healthcare Services, L.L.C. | Personal Emergency Response Attendant | 146 Deer Point Rd, Unionville, TN 37180-8500 | 2007-02-19 |
| 1376609230 | Lifesafe Security Corporation | Personal Emergency Response Attendant | 5324 Highway 104 West, Dyersburg, TN 38024 | 2006-12-28 |
| 1336257195 | Ronald Martin | Personal Emergency Response Attendant | 9053 Spring Grove Cv, Cordova, TN 38018-7493 | 2006-08-29 |
| 1154351971 | Jan Allen Dewitt | Personal Emergency Response Attendant | 109 Land Oak Rd, Knoxville, TN 37922-2011 | 2006-07-04 |
| 1811942964 | William Brent Evans | Personal Emergency Response Attendant | 1244 No Main St, Ste201, Tooele, TN 84074 | 2006-05-24 |
| 1588220529 | Catrina A Puckett | Personal Emergency Response Attendant | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2019-05-15 |
| 1285028183 | Kimberly Charee Bradd | Personal Emergency Response Attendant | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2015-03-28 |
| 1790020485 | Lifesafe LLC | Personal Emergency Response Attendant | 5324 Highway 104 West, Dyersburg, TN 38024 | 2012-12-06 |
| 1497879068 | Jerilyn Marie Oaks | Personal Emergency Response Attendant | Corner of Lamont and Veterans Way, James H Quillen Va Medical Center, Mountain Home, TN 37684-4000 | 2007-03-19 |
| 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.