Mountain States Health Alliance
NPI 1124426259ActiveOrganization· Pediatrics· Johnson City, TN
Pediatrics in Johnson City, Tennessee, registered in NPPES in December 2014. The authorized official on file is Mary Lynn Krutak, Evp/Cfo.
Overview
| NPI | 1124426259 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 5, 2014 |
| Last updated in NPPES | Feb 26, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
| Pediatrics, Pediatric Critical Care Medicine | 2080P0203X | — | — |
| Nurse Practitioner, Pediatrics | 363LP0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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