WELLMONT HEALTH SYSTEM (NPI# 1487690400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487690400 |
| Entity Type | Organization |
| Organization Name | WELLMONT HEALTH SYSTEM |
| Other Organization Name | HOLSTON VALLEY MEDICAL CENTER |
| Practice Address |
130 W Ravine Rd Kingsport TN 37660 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 4232244000 |
| Mailing Telephone | 4232244000 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-09-03 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | UMWA IN-PATIENT | 0039632 | 01 |
| NC | 4400017 | 05 | |
| TN | UHC RIVER VALLEY | A3766001 | 01 |
| WV | 0169767000 | 05 | |
| TN | TN BLUE CROSS | 1000805 | 01 |
| TN | 100020304 | 05 | |
| TN | POSTAL WORKERS DEPT OF LA | 166592401 | 01 |
| FL | 092263300 | 05 | |
| TN | A3766001 | 05 | |
| VA | 004400178 | 05 | |
| KY | 0162200000 | 05 | |
| TN | BLACK LUNG | 036101100 | 01 |
| TN | 1000805 | 05 | |
| LA | 1741825 | 05 | |
| TN | UMWA OUT-PATIENT | 0039640 | 01 |
| TN | AETNA | 6530375 | 01 |
| TN | 0440017 | 05 | |
| VA | ANTHEM BLUE CROSS | 240866 | 01 |
| Other Name | Type Code |
|---|---|
| HOLSTON VALLEY MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568905925 | Wellmont Health System | Clinic/Center | 1519 Main Street, Sneedville, TN 37869 | 2016-12-02 |
| 1316130602 | Wellmont Health System | Skilled Nursing Facility | 310 3rd St Ne, Norton, VA 24273 | 2007-08-21 |
| 1407049877 | Wellmont Health System | General Acute Care Hospital | 9480 Hwy 805, Jenkins, KY 41537-0472 | 2007-08-20 |
| 1144437716 | Wellmont Health System | Assisted Living Facility | 2000 Greenway St, Kingsport, TN 37660-3020 | 2007-05-16 |
| 1760493258 | Wellmont Health System | Pharmacy | 1980 Holton Ave E # 1, Big Stone Gap, VA 24219-3366 | 2006-08-10 |
| 1760405849 | Wellmont Health System | Psychiatric Unit | 1905 American Way, Kingsport, TN 37660-5882 | 2006-07-26 |
| 1962432088 | Wellmont Health System | Hospice, Inpatient | 280 Steeles Rd, Bristol, TN 37620 | 2006-07-04 |
| 1033191044 | Wellmont Health System | Home Health | Cloverleaf Square, Building G, Big Stone Gap, VA 24219 | 2005-11-16 |
| 1972884005 | Wellmont Health System | Clinic/Center | 671 Highway 58 E, Norton, VA 24273-3007 | 2011-09-02 |
| 1326329459 | Wellmont Health System | Spec/Tech, Cardiovascular | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2011-09-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | WELLMONT HEALTH SYSTEM | 303 Med Tech Parkway, Suite 300, Johnson City, Tennessee 37604 |
| Street Address |
130 W RAVINE RD |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536997 | Medical Mall Pharmacy Inc | Pharmacy | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2005-05-27 |
| 1598364903 | Kevin White | Physician Assistant | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-10-19 |
| 1093328460 | Corbin Noah Turbyfill | Registered Nurse | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-08-26 |
| 1871106153 | Garon Rick Compton | Registered Nurse | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-08-26 |
| 1780297010 | Caleb Rumley | Registered Nurse | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-08-26 |
| 1992314587 | Ryan Earl Farmer | Emergency Medicine | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-07-29 |
| 1043837933 | Verna Theola Barton | Pharmacist | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-06-26 |
| 1962028043 | Kendra Lauren O'quinn | Nurse Practitioner | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-06-24 |
| 1427673672 | Brooke Stayer | Pharmacist | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-06-13 |
| 1982228847 | Jordan Bacon | Physician Assistant | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-06-05 |
| Find all providers in the same location | ||||
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720468200 | Mountain States Health Alliance | General Acute Care Hospital | 2204 Pavilion Dr, Suite 115, Kingsport, TN 37660-4657 | 2015-06-01 |
| 1053674655 | Wellmont Integrated Network | General Acute Care Hospital | 1905 American Way, Kingsport, TN 37660-5882 | 2012-06-19 |
| 1992813240 | Mountain States Health Alliance | General Acute Care Hospital | 2000 Brookside Dr, Kingsport, TN 37660-4627 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174033906 | Behavioral Health of Rocky Top, LLC | General Acute Care Hospital | 210 Industrial Park Dr, Rocky Top, TN 37769-2301 | 2017-10-06 |
| 1104290667 | Michelle Mcconnell Spradley | General Acute Care Hospital | 5006 Dell Dr, Mount Juliet, TN 37122-4157 | 2015-11-20 |
| 1215301981 | Cheryl Hall Wideman | General Acute Care Hospital | 3721 Russell Hurst Dr E, Bartlett, TN 38135-1965 | 2015-11-18 |
| 1104206135 | Vanderbilt University | General Acute Care Hospital | 62 Parks Ln, Fayetteville, TN 37334-6642 | 2015-06-04 |
| 1306247515 | Fort Sanders Regional Medical Center | General Acute Care Hospital | 614 Emory Oak Ct, Knoxville, TN 37909-3439 | 2014-09-07 |
| 1740609130 | Select Specialty | General Acute Care Hospital | 2000 Hayes St Ste 1502, Nashville, TN 37203-2318 | 2014-04-14 |
| 1710301320 | Veronica Blackman | General Acute Care Hospital | 447 Shelley Renee Ln, Cordova, TN 38018-4310 | 2014-02-18 |
| 1962826107 | Hoke Steven Fitzgerald | General Acute Care Hospital | 1073 Smithfield Rd, Tellico Plains, TN 37385-6137 | 2014-02-07 |
| 1336560598 | Vanderbilt University Medical Center | General Acute Care Hospital | 607 Medical Arts Building, 1121 21st Avenue South, Nashville, TN 37232-1320 | 2013-12-13 |
| 1710314554 | Centennial | General Acute Care Hospital | 552 Metroplex Dr, Nashville, TN 37211-3133 | 2013-10-10 |
| Find all providers with the same taxonomy | ||||
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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.