INDIAN PATH PAVILION
NPI 1417050980
Psychiatric Unit in Kingsport, TN
NPI Status: Active since September 07, 2006
Contact Information
2300 PAVILION DR
KINGSPORT, TN
ZIP 37660
Phone: (423) 857-5500
Fax: (423) 857-7078
- Organization
- Psychiatric Unit
- CLIA Number: 44D0311044
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 03-14-2027
About INDIAN PATH PAVILION
This page provides the complete NPI Profile along with additional information for Indian Path Pavilion, a provider established in Kingsport, Tennessee operating as a Psychiatric Unit. The healthcare provider is registered in the NPI registry with number 1417050980 assigned on September 2006. The practitioner's primary taxonomy code is 273R00000X with license number 0000000134 (TN). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Indian Path Pavilion. The authorized official of this NPI record is Mrs. Mary L Krutak (Svp/cfo)
- NPI
- 1417050980
- Provider Legal Name
- MOUNTAIN STATES HEALTH ALLIANCE
- Other Organization Name
- INDIAN PATH PAVILION
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2300 PAVILION DR KINGSPORT, TN 37660
- Location Phone
- (423) 857-5500
- Location Fax
- (423) 857-7078
- Mailing Address
- 311 PRINCETON RD JOHNSON CITY, TN 37601
- Mailing Phone
- (423) 431-1941
- Mailing Fax
- (423) 857-7078
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-07-2006
- Last Update Date
- 10-15-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatric Unit
- Taxonomy Code
- 273R00000X
- Type
- Hospital Units
- License No.
- 0000000134
- License State
- TN
- Taxonomy Description
- In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4699873 | MEDICAID (05) | MI | |
| 4400176 | MEDICAID (05) | NC | |
| 44S0176 | MEDICARE OSCAR/CERTIFICATION (06) | TN | |
| 00672239 | MEDICAID (05) | MS | |
| 01600113 | MEDICAID (05) | KY | |
| 091618800 | MEDICAID (05) | FL | |
| 000127730 | MEDICAID (05) | SC | |
| 0938025 | MEDICAID (05) | OH | |
| 17505000 | OTHER (01) | MEGELLAN | |
| 000363855X | MEDICAID (05) | GA | |
| 004401760 | MEDICAID (05) | VA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D0311044
- Facility Type
- Hospital
- Certificate Effective Date
- March 15, 2025
- Certificate Expiration Date
- March 14, 2027
- Laboratory Director
- DR. THOMAS A. BARKLOW
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Indian Path Pavilion on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417050980, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
KINGSPORT, TN 37660
KINGSPORT, TN 37660
KINGSPORT, TN 37660
KINGSPORT, TN 37660
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417050980, enumerated as an "organization" on September 07, 2006.
The provider is located at 2300 PAVILION DR KINGSPORT, TN 37660 and the phone number is (423) 857-5500.
Psychiatric Unit with taxonomy code 273R00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
