NPIMap

Organization Active NPI

Mountain States Health Alliance

Doing business as Russell County Hospital Rehabilitation- St. Paul

  • General Acute Care Hospital
  • Saint Paul, VA
National Provider Identifier
1346620655
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Doing business as
Russell County Hospital Rehabilitation- St. Paul
Practice address
16431 Wise Street
Saint Paul, VA 24283
Phone
(276) 762-2300
Fax
(276) 762-0612
NPI assigned
Jun 2, 2015
Last updated
Feb 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X VA Primary

Addresses

Primary practice location

16431 Wise Street
Saint Paul, VA 24283

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2026
Phone (276) 762-2300

Other names 1

  • Russell County Hospital Rehabilitation- St. Paul 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

Locations

16431 Wise St
Saint Paul, VA 24283
Phone (276) 762-2300

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1346620655",
    "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": "276-762-2300",
            "fax_number": "276-762-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16431 WISE STREET",
            "city": "SAINT PAUL",
            "state": "VA",
            "postal_code": "24283",
            "telephone_number": "276-762-2300",
            "fax_number": "276-762-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2019-02-04",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russell County Hospital Rehabilitation- St. Paul",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.