Wellmont Medical Associates, Inc.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

WELLMONT MEDICAL ASSOCIATES, INC.

Doing business as

Ballad Health Imaging Center, Johnson City

Practice address

301 Med Tech Pkwy
Johnson City, TN 37604-2630

Phone

(423) 302-6239

Fax

(423) 302-6248

NPI assigned

May 5, 2021

Last updated

May 21, 2021By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Ballad Health Imaging Center, Johnson City Doing business as

Member of 1

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

• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Urgent Care Clinic/Center
  • Gray, TN
  • NPI 1144770934

  Member Of

  NPD member

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1740863968",
    "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": "376012080",
            "telephone_number": "423-302-6239",
            "fax_number": "423-302-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042630",
            "telephone_number": "423-302-6239",
            "fax_number": "423-302-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMONT MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "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": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Imaging Center, Johnson City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ballad Health Imaging Center, Johnson City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Eli Welch, MD
• David Brent Welch, M.D.
• Jewel B Welch, CRNAP
• Wellmont Medical Associates, Inc. (Ballad Health Medical Associates)
• Wellmont Medical Associates, Inc. (Ballad Health Medical Associates)
• Courtney Wells Currier
• Debbie Wells-Good, FNP
• Emily Wells, RD
• James Michael Wells, MD
• Tamie D Wells, MD

• Physiological Laboratory in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physiological Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.