| Mountain States Health Alliance | |
|
58 Carroll St Suite 3 Dept Of Russell County Medical Center Lebanon VA 24266 | |
| (276) 883-8340 | |
| (276) 883-8341 |
| Full Name | Mountain States Health Alliance |
|---|---|
| Speciality | Clinic/Center |
| Location | 58 Carroll St Suite 3, Lebanon, Virginia |
| Authorized Official Name and Position | Carl Kilgore (PRESIDENT) |
| Authorized Official Contact | 4239155185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain States Health Alliance 58 Carroll St Suite 3 Dept Of Russell County Medical Center Lebanon VA 24266 Ph: (276) 883-8340 | Mountain States Health Alliance 58 Carroll St Suite 3 Dept Of Russell County Medical Center Lebanon VA 24266 Ph: (276) 883-8340 |
| NPI Number | 1245781954 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 6002726718 |
|---|---|
| Medicare Enrollment ID | O20161216000941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245781954 | NPI | - | NPPES |
| 1245781954 | Medicaid | VA | |
| 020157701 | Other | VA | DEPARTMENT OF LABOR |
| Provider Name | Thomas Renfro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497726376 PECOS PAC ID: 1658459805 Enrollment ID: I20080429000233 |
| Provider Name | Rasmiyah M Jastan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740474527 PECOS PAC ID: 2365595493 Enrollment ID: I20130401000279 |
| Provider Name | Edgar Kahn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225181217 PECOS PAC ID: 3173571874 Enrollment ID: I20171108001308 |
| Provider Name | Trenton Keel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194197475 PECOS PAC ID: 9830498674 Enrollment ID: I20190110001935 |
| Provider Name | Emily B Crabtree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639525975 PECOS PAC ID: 9638463037 Enrollment ID: I20210428000545 |
| Provider Name | Christa Setser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659980373 PECOS PAC ID: 3173934965 Enrollment ID: I20210804003582 |
| Provider Name | Andrew Jordan Rosenfeld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740772359 PECOS PAC ID: 9032468160 Enrollment ID: I20220816001950 |
| Provider Name | Caitlin Riden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881248664 PECOS PAC ID: 8224465075 Enrollment ID: I20221118001808 |
| Provider Name | Helen Audra Chafin-hobert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003534975 PECOS PAC ID: 6103296330 Enrollment ID: I20230105000751 |
| Provider Name | Steven Lester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902688377 PECOS PAC ID: 2062858392 Enrollment ID: I20240308003664 |
| Provider Name | Toney Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265823330 PECOS PAC ID: 5395038400 Enrollment ID: I20240403000096 |
| Provider Name | Laura Marie Walts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003187477 PECOS PAC ID: 3476077835 Enrollment ID: I20250407002436 |
Family Health Care Associates Of Swva.,pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 143 W Main St, Lebanon, VA 24266 Phone: 276-889-2394 Fax: 276-889-4716 | |
Blue Ridge Medical Managment Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 58 Carroll St, Room 2037, Lebanon, VA 24266 Phone: 276-883-8062 Fax: 276-883-8064 | |
C-health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 495 East Main Street, Lebanon, VA 24266 Phone: 276-889-3700 Fax: 276-889-5505 | |
Merit Medical Rhc Lebanon Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 West Main Street, Lebanon, VA 24266 Phone: 276-889-0035 Fax: 276-889-2044 | |
Mountain States Health Alliance Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 344 Overlook Dr Ste 100, Lebanon, VA 24266 Phone: 276-883-8042 Fax: 276-883-8044 | |
Wellmont Medical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 344 Overlook Dr, Lebanon, VA 24266 Phone: 276-883-5900 Fax: 276-883-5899 |