NPIMap

Organization Active NPI

Mountain States Health Alliance

  • Diagnostic Radiology Physician
  • Lebanon, VA
National Provider Identifier
1104158054
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Practice address
58 Carroll St
Lebanon, VA 24266-3600
Phone
(276) 883-8101
Fax
(276) 889-4336
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Eddie C Greene
Title
Avp/Administrator
Phone
(246) 883-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

58 Carroll St
Lebanon, VA 24266-3600

Mailing address

PO Box 3600
Lebanon, VA 24266-0200
Phone (276) 883-8101

Other names 1

  • RCMC Nighthawk Readings Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mountain States Health Alliance41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1104158054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3600",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242660200",
            "telephone_number": "276-883-8101",
            "fax_number": "276-889-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CARROLL ST",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242663600",
            "telephone_number": "276-883-8101",
            "fax_number": "276-889-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AVP/ADMINISTRATOR",
        "authorized_official_telephone_number": "246-883-8101"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RCMC Nighthawk Readings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.