Mountain Empire Radiology Inc PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MOUNTAIN EMPIRE RADIOLOGY INC PC

Practice address

1301 Sunset Dr
Ste 3
Johnson City, TN 37604-7906

Phone

(423) 926-4966

Fax

(423) 926-1823

NPI assigned

May 28, 2006

Last updated

Aug 22, 2020By 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

David C Lucas

Title

Practice Administrator

Phone

(423) 926-4966

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Enrollment records 2

Locations

Practitioners 57

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.

• Arthur Austin, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1073590584

  VA

  Medicare reassignment NPD
• Brooklyn Beaupre, AG-ACNP

  • Acute Care Nurse Practitioner
  • Johnson City, TN
  • NPI 1336541259
  Medicare reassignment NPD
• Vincent Gerard Becker, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1184682494

  VA

  Medicare reassignment NPD
• Chirag A. Dani, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1265797179

  VA

  Medicare reassignment NPD
• Christopher Jordan Dela Houssaye, D.O.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1851688063

  VA

  Medicare reassignment NPD
• David A Forsberg, MD

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1629058300
  Medicare reassignment NPD
• Katherine Collier Frederick-Dyer

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1932424629
  Medicare reassignment NPD
• Glen H Hatcher, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1316995749

  VA

  Medicare reassignment NPD
• Perry Jernigan, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1164473005

  VA

  Medicare reassignment NPD
• James Koonce, MD

  • Neuroradiology Physician
  • Johnson City, TN
  • NPI 1851480776

  Diagnostic Radiology, VA

  Medicare reassignment NPD
• Ethel L Longmire O'Neal, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1205807351

  VA

  Medicare reassignment NPD
• Marianne R Neal, M.D.

  • Diagnostic Radiology Physician
  • Johnson City, TN
  • NPI 1255380317

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093762759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SUNSET DR",
            "address_2": "STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047906",
            "telephone_number": "423-926-4966",
            "fax_number": "423-926-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SUNSET DR",
            "address_2": "STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047906",
            "telephone_number": "423-926-4966",
            "fax_number": "423-926-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN EMPIRE RADIOLOGY INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "423-926-4966"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAID",
            "identifier": "8902245",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "65927972",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378531",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Wesley Mosier III, PSY. D.
• Joshua W Mosley, F.N.P.
• Robert P Mothershead, CRNA
• David F Moulton, MD
• Ketrin Hill Mount, PHARMD
• Mountain Empire Surgery Center LP
• Mountain Haven Counseling Center
• Mountain Heritage Builders LLC
• Mountain Home Vamc
• Mountain States Health Alliance (Johnson City Specialty Hospital)

• Diagnostic Radiology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.