NPIMap

Organization Active NPI

Frontier Health

Doing business as Magnolia Ridge

  • Substance Abuse Rehabilitation Facility
  • Johnson City, TN
National Provider Identifier
1053476333
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
430 Issued in TN
Legal business name
FRONTIER HEALTH
Doing business as
Magnolia Ridge
Practice address
208 E Unaka Ave
Johnson City, TN 37601-4626
Phone
(423) 906-0940
Fax
(423) 467-3644
NPI assigned
Dec 27, 2006
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Cristi Lynn BlalockNPI 1730685504
Title
Director of Contracting/Reg. Comp.
Phone
(423) 467-3741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 430 TN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

208 E Unaka Ave
Johnson City, TN 37601-4626

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

Other names 1

  • Magnolia Ridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lee County Integrated Care62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

  • Frontier Health

    dba Adolescent Drug and Alcohol Recovery

    • Adolescent and Children Mental Health Clinic/Center
    • Bristol, TN
    • NPI 1013078716
    NPD tax ID
  • Frontier Health

    dba Hawkins County Mental Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Rogersville, TN
    • NPI 1043374564
    NPD tax ID
  • Frontier Health

    dba Hancock County Mental Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sneedville, TN
    • NPI 1053475558
    NPD tax ID
  • Frontier Health

    dba Fairmount Group Home

    • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
    • Bristol, TN
    • NPI 1073735643
    NPD tax ID
  • Frontier Health
    • Psychiatric Hospital Unit
    • Johnson City, TN
    • NPI 1093958944
    NPD tax ID
  • Frontier Health

    dba Gibson Place 210

    • Psychiatric Residential Treatment Facility
    • Johnson City, TN
    • NPI 1124463849
    NPD tax ID
  • Frontier Health

    dba Fairview Associates of Johnson City

    • Community/Behavioral Health Agency
    • Johnson City, TN
    • NPI 1134282551
    NPD tax ID
  • Frontier Health
    • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
    • Kingsport, TN
    • NPI 1144460817
    NPD tax ID
  • Frontier Health

    dba Crisis Triage

    • Community/Behavioral Health Agency
    • Johnson City, TN
    • NPI 1174005276
    NPD tax ID
  • Frontier Health

    dba Bristol Regional Counseling Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Bristol, TN
    • NPI 1235291295
    NPD tax ID
  • Frontier Health

    dba Adventure Program

    • Adolescent and Children Mental Health Clinic/Center
    • Johnson City, TN
    • NPI 1235298720
    NPD tax ID
  • Frontier Health

    dba Roller Russ Residence for Independent Living

    • Mental Illness Community Based Residential Treatment Facility
    • Kingsport, TN
    • NPI 1265597280
    NPD tax ID
View all 15

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1053476333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E UNAKA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014626",
            "telephone_number": "423-906-0940",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "CRISTI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING/REG. COMP.",
        "authorized_official_telephone_number": "423-467-3741"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "430",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.