NPIMap

Organization Active NPI

Mountain States Health Alliance

Doing business as Bhrhc St Paul

  • Rural Health Clinic/Center
  • Saint Paul, VA
National Provider Identifier
1386813616
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Doing business as
Bhrhc St Paul
BHRHC St. Paul
MSMG FP St PA
Practice address
16431 Wise St
St Paul, VA 24283
Phone
(276) 762-2300
Fax
(276) 762-0612
NPI assigned
Feb 20, 2008
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Juanita Harwood
Title
Director
Phone
(423) 392-6565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

16431 Wise St
St Paul, VA 24283

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6567

Other names 3

  • BHRHC ST PAUL Doing business as
  • BHRHC St. Paul Doing business as
  • MSMG FP ST PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161216000941 VA Part B Supplier - Clinic/Group Practice 6002726718 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, VA; Saint Paul, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1386813616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6567",
            "fax_number": "276-762-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16431 WISE ST",
            "city": "ST 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": "2008-02-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "HARWOOD",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-392-6565"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHRHC ST PAUL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHRHC St. Paul",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG FP ST PA",
            "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 Aug 12, 2024; 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.