NPIMap

Organization Active NPI

Mountain States Health Alliance Indian Path Medical Center

  • General Acute Care Hospital
  • Johnson City, TN
National Provider Identifier
1992869556
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0000000134 Issued in TN
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE INDIAN PATH MEDICAL CENTER
Practice address
400 N State of Franklin Rd
Managed Care Administration
Johnson City, TN 37604-6035
Phone
(423) 431-3548
Fax
(423) 431-3549
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dennie Vonderfecht
Title
Ceo
Phone
(423) 431-1009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000000134 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Managed Care Administration
Johnson City, TN 37604-6035

Mailing address

400 N State of Franklin Rd
Managed Care Administration
Johnson City, TN 37604-6035
Phone (423) 431-3548

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992869556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "MANAGED CARE ADMINISTRATION",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-3548",
            "fax_number": "423-431-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "MANAGED CARE ADMINISTRATION",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-3548",
            "fax_number": "423-431-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE INDIAN PATH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VONDERFECHT",
        "authorized_official_first_name": "DENNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-431-1009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "0000000134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.