Organization Active NPI

Crestpoint Psychiatric Care, LLC

Doing business as Faith Aimua

  • Psychiatry Physician
  • Johnson City, TN
National Provider Identifier
1679040075
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CRESTPOINT PSYCHIATRIC CARE, LLC
Doing business as
Faith Aimua
Practice address
206 Princeton Rd Ste 18
Johnson City, TN 37601-2025
Phone
(423) 631-0024
Fax
(423) 631-0047
NPI assigned
Oct 24, 2018
Last updated
Jul 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Faith Aimua, M.DNPI 1538450408
Title
Psychiatrist
Phone
(423) 631-0024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

206 Princeton Rd Ste 18
Johnson City, TN 37601-2025

Mailing address

PO Box 4358
Johnson City, TN 37602-4358
Phone (423) 913-4188

Other names 1

  • Faith Aimua Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181102001320 TN Part B Supplier - Clinic/Group Practice 0840543104 Receives reassigned benefits from 1 practitioner
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Locations

206 Princeton Rd
Ste 18
Johnson City, TN 37601
Phone (423) 631-0024

806 E Jackson Blvd
Ste 9
Jonesborough, TN 37659
Phone (423) 289-0819

Practitioners & affiliated clinicians

Practitioners 1

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": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1679040075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4358",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376024358",
            "telephone_number": "423-913-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PRINCETON RD STE 18",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012025",
            "telephone_number": "423-631-0024",
            "fax_number": "423-631-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTPOINT PSYCHIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "AIMUA",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "423-631-0024",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faith Aimua",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Faith Aimua",
            "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 Jul 28, 2020; 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.