MOUNTAIN EMPIRE RADIOLOGY INC PC NPI 1093762759

NPI Information

  • NPI: 1093762759
  • Provider Name: MOUNTAIN EMPIRE RADIOLOGY INC PC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 1301 SUNSET DR
    STE 3
    JOHNSON CITY, TN
    ZIP 37604
  • Phone: (423) 926-4966

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NPI Details

MOUNTAIN EMPIRE RADIOLOGY INC PC is a diagnostic radiology radiology in Johnson City, TN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MOUNTAIN EMPIRE RADIOLOGY INC PC NPI is 1093762759. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1301 SUNSET DR
STE 3
JOHNSON CITY, TN
ZIP 37604-906
Phone: (423) 926-4966
Fax: (423) 926-1823

The provider's authorized official is David C Lucas .
The authorized official title is Practice Administrator and has the following contact phone number (423) 926-4966.

The enumeration date for this NPI number is 5/28/2006 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyTENNESSEEYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
165927972OTHERKENTUCKYKENTUCKY MEDICAID
23378531MEDICAIDTENNESSEE
38902245OTHERNORTH CAROLINANORTH CAROLINA MEDICAID

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: 11/21/2025

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