Mountain States Health Alliance
NPI 1124426259 · Pediatrics Physician · Johnson City, TN
Mountain States Health Alliance is a Pediatrics Physician organization in Johnson City, TN (NPI 1124426259).
Provider details
- NPI number
- 1124426259
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Krutak, Evp/Cfo(423) 302-3423
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-12-05
- Last updated
- 2018-02-26
Frequently asked questions
- What is Mountain States Health Alliance's NPI number?
- Mountain States Health Alliance's National Provider Identifier (NPI) is 1124426259, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mountain States Health Alliance?
- Mountain States Health Alliance is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Mountain States Health Alliance located?
- Mountain States Health Alliance's practice location on file with NPPES is 400 N State of Franklin Rd, Johnson City, TN 37604-6035.
- What is Mountain States Health Alliance's phone number?
- The practice phone number listed in the NPPES registry for Mountain States Health Alliance is (423) 431-4847.
- Who is the authorized official for Mountain States Health Alliance?
- The authorized official listed on Mountain States Health Alliance's NPPES record is Mary Krutak, Evp/Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mountain States Health Alliance's NPI active?
- Yes — Mountain States Health Alliance's NPI (1124426259) is active in the NPPES registry as of the last update on 2018-02-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.