NPIMap

Organization Active NPI

Mountain States Health Alliance

Doing business as Mountain States Rehabilitation at RCMC

  • General Acute Care Hospital
  • Lebanon, VA
National Provider Identifier
1619357928
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H 1892 Issued in VA
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Doing business as
Mountain States Rehabilitation at RCMC
Practice address
111 S Flannagan Avenue
Lebanon, VA 24266-4515
Phone
(276) 883-8095
Fax
(276) 883-8097
NPI assigned
Jun 2, 2015
Last updated
Mar 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 H 1892 VA Primary

Addresses

Primary practice location

111 S Flannagan Avenue
Lebanon, VA 24266-4515

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2026
Phone (276) 883-8095

Other names 1

  • Mountain States Rehabilitation at RCMC 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": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1619357928",
    "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": "276-883-8095",
            "fax_number": "276-883-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FLANNAGAN AVENUE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664515",
            "telephone_number": "276-883-8095",
            "fax_number": "276-883-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2018-03-29",
        "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": "H 1892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain States Rehabilitation at RCMC",
            "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 Mar 29, 2018; 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.