Mountain States Health Alliance
Pediatrics
Mountain States Health Alliance is a Johnson City, Tennessee based Pediatric center with medical specialization in
General Pediatrics.
It is located at
400 N State Of Franklin Rd, Niswonger Children's Hospital Admin, Johnson City, Tennessee - 37604-6035. They can be contacted on phone at
423-431-4847 and fax number 423-431-3949.
NPI number (Unique professional ID) for Mountain States Health Alliance is
1124426259 which was assigned by NPPES on 05 Dec, 2014 and it was last updated on 26 Feb, 2018.
Mountain States Health Alliance is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Mountain States Health Alliance basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Mountain States Health Alliance |
|---|
Business Address:
Mountain States Health Alliance address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 400 N State Of Franklin Rd, Niswonger Children's Hospital Admin
Johnson City, TN, 37604-6035
United States |
|---|
| Phone Number : | 423-431-4847 |
|---|
| Fax Number : | 423-431-3949 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1124426259 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 05 Dec, 2014 |
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| Last Updated On : | 26 Feb, 2018 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Marylynn Krutak |
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| Official Title or Position : | EVP/CFO |
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| Phone Number : | 423-302-3423 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mountain States Health Alliance are as mentioned. Primary taxonomy code for Mountain States Health Alliance is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
| 2080P0203X | Pediatrics Pediatric Critical Care Medicine | No | | |
| 363LP0200X | Nurse Practitioner Pediatrics | No | | |
Legacy Identifiers:
Other legacy medical identifiers of Mountain States Health Alliance such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| Q010765 | MEDICAID | TN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 311 Princeton Rd Ste 1
Johnson City, TN, 37601-2026
United States |
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| Phone Number : | 423-431-4847 |
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| Fax Number : | 423-431-3949 |
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Business Location:
Patients can refer following map for directions to
Mountain States Health Alliance practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.