NPIMap

Organization Active NPI

Mountain States Health Alliance

  • Skilled Nursing Facility
  • Johnson City, TN
National Provider Identifier
1124139464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000329 Issued in TN
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Practice address
2511 Wesley St
Johnson City, TN 37601-1723
Phone
(423) 952-1700
Fax
(423) 952-3398
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Marvin H Eichorn
Title
SVP/Cfo
Phone
(423) 431-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0000000329 TN Primary

Addresses

Primary practice location

2511 Wesley St
Johnson City, TN 37601-1723

Mailing address

2511 Wesley St
Johnson City, TN 37601-1723
Phone (423) 952-1700

Other names 1

  • Johnson City Medical Center Skilled Nursing Facility Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124139464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 WESLEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011723",
            "telephone_number": "423-952-1700",
            "fax_number": "423-952-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 WESLEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011723",
            "telephone_number": "423-952-1700",
            "fax_number": "423-952-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EICHORN",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SVP/CFO",
        "authorized_official_telephone_number": "423-431-6111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson City Medical Center Skilled Nursing Facility",
            "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 Aug 22, 2020; 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.