OrganizationActive
Mountain States Health Alliance
NPI 1417050980 · Psychiatric Hospital Unit · Kingsport, TN
Mountain States Health Alliance is a Psychiatric Hospital Unit organization in Kingsport, TN (NPI 1417050980).
Provider details
- NPI number
- 1417050980
- Entity type
- Organization
- Primary specialty
- Psychiatric Hospital UnitHospital Units
- Organization subpart
- No
- Authorized official
- Mary Krutak, Svp/Cfo(423) 431-6111
- License
- 0000000134 (TN)
Specialties & taxonomies
Hospital Units
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone: (423) 857-5500
Fax: (423) 857-7078
Street-level locationGet directions
Mailing address
311 Princeton Rd
Johnson City, TN 37601-2026
Other names (DBA / former)
- Doing business as
- Indian Path Pavilion
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2015-10-15
Frequently asked questions
- What is Mountain States Health Alliance's NPI number?
- Mountain States Health Alliance's National Provider Identifier (NPI) is 1417050980, 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 Psychiatric Hospital Unit (Hospital Units).
- Where is Mountain States Health Alliance located?
- Mountain States Health Alliance's practice location on file with NPPES is 2300 Pavilion Dr, Kingsport, TN 37660-4622.
- 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) 857-5500.
- 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, Svp/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 (1417050980) is active in the NPPES registry as of the last update on 2015-10-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.