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NPI Code Detail

MEDICARE: FRONTIER HEALTH

MEDICARE: FRONTIER HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
32084P0800XPsychiatry Physician
4101YP2500XProfessional Counselor
5324500000XSubstance Abuse Rehabilitation Facility430TN

General Provider Information

NPI Number : 1053476333
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRONTIER HEALTH
Provider Business Mailing Address
First Line : 1167 SPRATLIN PARK DR
Second Line :
City : GRAY
State : TN
Zip : 37615-6205
Country : US
Telephone Number : 423-467-3600
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 208 E UNAKA AVE
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-4626
Country : US
Telephone Number : 423-906-0940
Fax Number : 423-467-3644
Authorized Official
Title or Position : DIRECTOR OF CONTRACTING/REG. COMP.
Name : CRISTI LYNN BLALOCK
Credential :
Telephone Number : 423-467-3741
Provider Enumeration Date : 12/27/2006
Last Update Date : 10/13/2025

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Directions to “FRONTIER HEALTH ” Practice Location

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