Provider Type Icon

MOUNTAIN STATES HEALTH ALLIANCE NPI 1972606465


NPI Information

NPI: 1972606465
Provider Name: MOUNTAIN STATES HEALTH ALLIANCE

Doing Business As: JOHNSON CITY MEDICAL CENTER

Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization

CLIA Number: 44D0310689

Address:
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-6111
Get Directions

MOUNTAIN STATES HEALTH ALLIANCE is a general acute care hospital in Johnson City, TN. The provider is 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. MOUNTAIN STATES HEALTH ALLIANCE NPI is 1972606465. The provider is registered as an organization entity type.
The provider Is Doing Business As Johnson City Medical Center.

The provider's business location address is:

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604-035
Phone: (423) 431-6111
Fax: (423) 431-3549

The provider's authorized official is Mary Lynn Krutak .
The authorized official title is Evp/cfo and has the following contact phone number (423) 302-3423.

The CLIA number assigned to this NPI record is 44D0310689 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 10/20/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1273R00000XPsychiatric Unit0000000121TENNESSEENo
2282N00000XGeneral Acute Care Hospital0000000121TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1070026OTHERCIGNA
2463496MEDICAIDSOUTH CAROLINA
34699882MEDICAIDMICHIGAN
49802156000MEDICAIDWEST VIRGINIA
5030283600OTHERBLACK LUNG
605431336MEDICAIDMISSISSIPPI
71749478MEDICAIDLOUISIANA
8JOH0063NMEDICAIDALABAMA
90440063MEDICAIDTENNESSEE
104400063MEDICAIDNORTH CAROLINA
1101620418MEDICAIDKENTUCKY
1242332MEDICAIDSOUTH CAROLINA
13000262138XMEDICAIDGEORGIA
144688190MEDICAIDMICHIGAN
15A3760501OTHERJOHN DEERE
1601675483MEDICAIDNEW YORK
170579913MEDICAIDOHIO
18091618800MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.