Wellmont Health System

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

Legal business name

WELLMONT HEALTH SYSTEM

Doing business as

Wellmont Hospice

Practice address

988 W Main St
Abingdon, VA 24210

Phone

(276) 619-4500

Fax

(423) 844-6379

NPI assigned

Jul 28, 2006

Last updated

Sep 4, 2018By 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

• WELLMONT HOSPICE Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Mountain States Health Alliance

  dba Ballad Health Hospice

  • Inpatient Hospice
  • Abingdon, VA
  • NPI 1336635192

  Sold to, 2018-07-01

  CMS change of ownership

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1871507426",
    "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": "276-619-4500",
            "fax_number": "423-844-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 W MAIN ST",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "24210",
            "telephone_number": "276-619-4500",
            "fax_number": "423-844-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMONT HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-09-04",
        "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": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WELLMONT HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLMONT HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Watauga Rehabilitation, Inc.
• Mitchell Todd Watson, D.C.
• Derek Webb, PHARM D
• Rebecca Kate Webb, PHARM D
• William McNeil Welborne, D.D.S.
• Wellmont Health System Inc
• Wellmont Medical Associates Inc (Ballad Health Medical Associates)
• Wellmont Medical Associates, Inc. (Ballad Health Medical Associates)
• Dawnyell Wells, LPC
• Mia R Wessels, MD

• Inpatient Hospice in Abingdon, VA
• Providers in Abingdon, VA by specialty
• Inpatient Hospice in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.