Blue Mountain Medical Clinic, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE MOUNTAIN MEDICAL CLINIC, PLLC

Practice address

1814 Cumberland Ave
Middlesboro, KY 40965

Phone

(606) 242-2519

Fax

(606) 242-2520

NPI assigned

Jun 23, 2017

Organization subpart

Yes

Parent organization

LIFE & HEALTH SERVICESAs reported in NPPES

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

Authorized official

Name

Tina Poore

Title

Office Manager

Phone

(606) 242-2519

Specialties & licenses 1

Addresses

Part of

Life Health Services

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Life & Health Services

  • Clinical Psychologist
  • Middlesboro, KY
  • NPI 1568864734
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grace Runions, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Pineville, KY
  • NPI 1104200864
  NPD

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1023538758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651229",
            "telephone_number": "606-242-2519",
            "fax_number": "606-242-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "40965",
            "telephone_number": "606-242-2519",
            "fax_number": "606-242-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN MEDICAL CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE & HEALTH SERVICES",
        "enumeration_date": "2017-06-23",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "POORE",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-242-2519"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joseph McKinley Boster, D.M.D.

• Family Medicine Physician in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.