Mountain States Health Alliance

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0000000390 Issued in TN

Legal business name

MOUNTAIN STATES HEALTH ALLIANCE

Doing business as

Ballad Health Hospice

Practice address

509 Med Tech Pkwy Ste 300
Johnson City, TN 37604-2579

Phone

(423) 431-6146

Fax

(423) 431-7655

NPI assigned

Aug 21, 2006

Last updated

Dec 19, 2018By 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 Hospice Doing business as

Member of 1

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

• Mountain States Health Alliance

  dba Bhrhc Mtncity

  • Rural Health Clinic/Center
  • Mountain City, TN
  • NPI 1518079532

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1033225206",
    "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": "423-431-6146",
            "fax_number": "423-431-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MED TECH PKWY STE 300",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042579",
            "telephone_number": "423-431-6146",
            "fax_number": "423-431-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-12-19",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TN",
            "license": "0000000390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mountain Haven Counseling Center
• Mountain Heritage Builders LLC
• Mountain Home Vamc
• Mountain States Health Alliance (Johnson City Specialty Hospital)
• Mountain States Health Alliance (Woodridge Hospital)
• Mountain States Health Alliance (Medical Center Infusion Therapy)
• Mountain States Health Alliance
• Mountain States Health Alliance
• Mountain States Health Alliance (Franklin Woods Community Hospital)
• Mountain States Health Alliance (Johnson City Medical Center Skilled Nursing Facility)

• Community Based Hospice Care Agency in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Community Based Hospice Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.