MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1326141896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326141896 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | INDIAN PATH MEDICAL CENTER TRANSITIONAL CARE UNIT |
| Practice Address |
2000 Brookside Dr Kingsport TN 37660-4627 |
| Mailing Address |
311 Princeton Rd Johnson City TN 37601-2026 |
| Practice Telephone | 4238577000 |
| Practice Fax Number | 4238577078 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-10-30 |
| Authorized Official Name | MR. MARY LYNN KRUTAK (SVP/CFO) |
| Authorized Official Telephone | 4233023774 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0000000336 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 004401760 | 05 | |
| MI | 4699873 | 05 | |
| SC | 000127730 | 05 | |
| FL | 091618800 | 05 | |
| OH | 0938025 | 05 | |
| NC | 4400176 | 05 | |
| MS | 00672239 | 05 | |
| GA | 000363855X | 05 | |
| KY | 01600113 | 05 |
| Other Name | Type Code |
|---|---|
| Indian Path Medical Center Transitional Care Unit | 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 |
2000 BROOKSIDE DR |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205825528 | Carol Ann Brown | Nurse Anesthetist, Certified Registered | 2000 Brookside Dr, Kingsport, TN 37660 | 2005-10-19 |
| 1548734338 | Jennifer Leigh Johnson | Nurse Practitioner | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2019-01-15 |
| 1730628785 | Amanda Genco | Clinical Nurse Specialist | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2017-02-22 |
| 1669918314 | Blue Ridge Medical Management Corporation | Hospitalist | 2000 Brookside Dr, 1st Floor Room 12, Kingsport, TN 37660-4627 | 2017-01-18 |
| 1134585326 | Michael John May | Nurse Practitioner | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2016-01-05 |
| 1386039006 | Susan Netherland | Occupational Therapist | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2015-03-31 |
| 1467859066 | Ariel Rockett | Physical Therapist | 2000 Brookside Dr, Kingsport, TN 37660 | 2014-11-25 |
| 1881097913 | Randi Teaster | Nurse Practitioner | 2000 Brookside Dr, 3rd Floor, Kingsport, TN 37660-4627 | 2014-10-03 |
| 1043627441 | Valley Ridge Emergency Physicians, LLP | Emergency Medicine | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2014-07-17 |
| 1184053472 | Madonna Lin Banks | Registered Nurse | 2000 Brookside Dr, 3rd Floor, Kingsport, TN 37660-4627 | 2013-11-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| 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 |
|---|---|---|---|---|
| 1386691889 | Sunrise Healthcare Corporation | Skilled Nursing Facility | 3641 Memorial Blvd, Kingsport, TN 37664-3422 | 2006-05-28 |
| 1871580886 | Kingsport Nh Operations, LLC | Skilled Nursing Facility | 2035 Stonebrook Place, Kingsport, TN 37660-4000 | 2005-10-04 |
| 1104301837 | Brookhaven Tn Opco LLC | Skilled Nursing Facility | 2035 E Stonebrook Pl, Kingsport, TN 37660-4000 | 2018-09-28 |
| 1215341383 | Nhc Healthcare-kingsport LLC | Skilled Nursing Facility | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2014-06-17 |
| 1356504393 | Holston Nh Operations LLC | Skilled Nursing Facility | 3641 Memorial Blvd, Kingsport, TN 37664-3422 | 2008-07-09 |
| 1053341545 | Wellmont Health System | Skilled Nursing Facility | 130 W Ravine Rd, Kingsport, TN 37660-3810 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093343535 | Marie Carmelle Noel | Skilled Nursing Facility | 800 Sadie Ann Ct, Smyrna, TN 37167-3445 | 2020-03-30 |
| 1396308508 | Decatur Operating Group LLC | Skilled Nursing Facility | 332 River Rd, Decatur, TN 37322-7800 | 2019-04-15 |
| 1760940613 | Marble City Medical LLC | Skilled Nursing Facility | 7500 Dodson Rd, Knoxville, TN 37920-9734 | 2019-03-11 |
| 1083132641 | Decatur Healthcare, LLC | Skilled Nursing Facility | 322 River Road, Decatur, TN 38322 | 2017-09-05 |
| 1285155705 | Stones River Manor, Inc. | Skilled Nursing Facility | 205 Haynes Dr, Murfreesboro, TN 37129-5101 | 2017-07-06 |
| 1821538562 | Red Bank Operations, LLC | Skilled Nursing Facility | 1020 Runyan Drive, Chattanooga, TN 37405 | 2017-02-28 |
| 1316482458 | East Ridge Snf Operations, LLC | Skilled Nursing Facility | 1502 Mcdonald Rd., East Ridge, TN 37412 | 2016-12-28 |
| 1639625254 | Emerald Spring Hill, Inc. | Skilled Nursing Facility | 2000 Reserve Boulevard, Spring Hill, TN 37174-2370 | 2016-09-01 |
| 1245786482 | Nhc-maury Regional Transitional Care Center LLC | Skilled Nursing Facility | 5010 Trotwood Ave, Columbia, TN 38401-4903 | 2016-08-28 |
| 1457805186 | Barton Blazer Smith | Skilled Nursing Facility | 210 Busbee Rd, Knoxville, TN 37920-5104 | 2016-08-11 |
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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.