Mountain States Health Alliance

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOUNTAIN STATES HEALTH ALLIANCE

Doing business as

Ballad Health Homecare

Practice address

75 S Flannagan Ave
Lebanon, VA 24266

Phone

(276) 883-8484

Fax

(276) 883-8495

NPI assigned

Jan 31, 2008

Last updated

Feb 26, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Lynn Krutak

Title

Evp / Cfo

Phone

(423) 302-3423

Specialties & licenses 1

Addresses

Other names 1

• Ballad Health Homecare Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mountain States Health Alliance

  dba Sycamore Shoals Hospital Psychiatric Unit

  • Psychiatric Hospital Unit
  • Elizabethton, TN
  • NPI 1710099742

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1013195155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "276-883-8484",
            "fax_number": "276-883-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S FLANNAGAN AVE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8484",
            "fax_number": "276-883-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "KRUTAK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EVP / CFO",
        "authorized_official_telephone_number": "423-302-3423"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Homecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ballad Health Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Michelle Miller, NURSE PRACTITIONER
• Madison Paige Miller
• Shelley Renea Miller, RN MSN FNP-C
• David M Mitchell, MD PHD
• Jean M Montgomery, NP
• Mountain States Health Alliance (Russell County Medical Center Anesthesiology Department)
• Mountain States Health Alliance (RCMC Nighthawk Readings)
• Mountain States Health Alliance (Ballad Health Hospice)
• Mountain States Health Alliance (Bhrhc Lebanon)
• Mountain States Health Alliance (MSMG Lebanon Family Practice)

• Home Health Agency in Lebanon, VA
• Providers in Lebanon, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.