{"npi":"1124058615","type":"NPI-2","status":"active","name":{"display":"Wellmont Health System","other":[],"organization_name":"WELLMONT HEALTH SYSTEM","authorised_official":"Shane Hilton"},"specialty":{"primary_taxonomy":"282N00000X","primary_taxonomy_description":"General Acute Care Hospital","slug":"general-acute-care-hospital","schema_org_specialty":null,"all":[{"code":"282N00000X","description":"General Acute Care Hospital","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1 MEDICAL PARK BLVD","city":"BRISTOL","state":"TN","postal_code":"376207430","country_code":"US","phone":"4238441121"},{"purpose":"MAILING","street_1":"311 PRINCETON RD STE 1","city":"JOHNSON CITY","state":"TN","postal_code":"376012026","country_code":"US","phone":"4238441121"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"6530115","state":"TN","issuer":"AETNA"},{"type_code":"05","label":"Medicaid","value":"004400127","state":"VA","issuer":null},{"type_code":"01","label":"Other","value":"1377051","state":"TN","issuer":"UMWA"},{"type_code":"01","label":"Other","value":"240867","state":"VA","issuer":"ANTHEM"},{"type_code":"05","label":"Medicaid","value":"A3762106","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"1000319","state":"TN","issuer":"TN BLUE CROSS"},{"type_code":"05","label":"Medicaid","value":"10260B","state":"SC","issuer":null},{"type_code":"01","label":"Other","value":"A3762106","state":"TN","issuer":"UHC RIVER VALLEY"},{"type_code":"05","label":"Medicaid","value":"100020309","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"033361400","state":"TN","issuer":"BLACK LUNG"},{"type_code":"05","label":"Medicaid","value":"0440012","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"166592403","state":"TN","issuer":"POSTAL WORKERS DEPT LAB"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040608000164","type_code":"00-09","type_desc":"PART A PROVIDER - HOSPITAL","state":"VA","pac_id":"2567360704"},{"enrlmt_id":"O20180125002244","type_code":"12-31","type_desc":"PART B SUPPLIER - INTENSIVE CARDIAC REHABILITATION","state":"TN","pac_id":"2567360704"}]},"enumeration_date":"2006-07-03","last_updated":"2024-04-16","_meta":{"source":"NPPES","snapshot_date":"2024-04-16","doc_url":"https://findmynpi.com/api"}}