JACKSON HOSPITAL AND CLINIC INC. (NPI# 1053844654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053844654 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC. |
| Other Organization Name | JACKSON CLINIC UROLOGY WETUMPKA |
| Practice Address |
515 Hospital Dr Suite A Wetumpka AL 36092-1626 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342938588 |
| Practice Fax Number | 3342936978 |
| Mailing Telephone | 3342938736 |
| Mailing Fax Number | 3342938738 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | TARA HERRING (REVENUE CYCLE DIRECTOR) |
| Authorized Official Telephone | 3342402337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Urology Wetumpka | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194256438 | Jackson Hospital and Clinic Inc. | Surgery | 1722 Pine St Ste 201, Montgomery, AL 36106-1158 | 2017-03-27 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1376097089 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 406, Montgomery, AL 36106-1103 | 2016-08-10 |
| 1588011746 | Jackson Hospital and Clinic Inc. | Surgery | 1801 Pine St, Suite 101, Montgomery, AL 36106-0165 | 2016-05-18 |
| 1164878856 | Jackson Hospital and Clinic Inc. | Internal Medicine | 461 E Main St, Prattville, AL 36067-3409 | 2016-05-11 |
| 1811350390 | Jackson Hospital and Clinic Inc. | Internal Medicine | 124 S Memorial Dr, Prattville, AL 36067-3619 | 2016-04-01 |
| 1528449386 | Jackson Hospital and Clinic Inc. | Durable Medical Equipment & Medical Supplies | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2015-06-17 |
| 1023317666 | Jackson Hospital and Clinic Inc. | Family Medicine | 1801 Pine Street, Suite 103, Montgomery, AL 36106-1160 | 2011-03-22 |
| Street Address |
515 HOSPITAL DR SUITE A |
| City | WETUMPKA |
| State | AL |
| Zip Code | 36092-1626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811421886 | Ivy Creek of Elmore LLC | Surgery | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 | 2017-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195525 | River Region Family Medicine, LLC | Family Medicine | 277 Huntress Street, Suite 100, Wetumpka, AL 36092 | 2020-02-07 |
| 1710548003 | 2la, LLC | Hearing Instrument Specialist | 4354 Us Highway 231, Suite A, Wetumpka, AL 36092 | 2019-06-26 |
| 1124549308 | Medi - Rides Transport LLC | Non-emergency Medical Transport (VAN) | 173 Hill Street, Suite 103, Wetumpka, AL 36092 | 2017-06-28 |
| 1538699129 | Joni Smart | Pharmacist | 4538 Us Hwy 231, Wetumpka, AL 36092 | 2017-06-15 |
| 1134396898 | Blue Ridge Chiropractic, LLC | Chiropractor | 2412 Us Hwy 231, Wetumpka, AL 36092 | 2008-05-13 |
| 1932243565 | Patricia Dianne White Mcclanahan | Psychologist | 8476 U S Hwy 231 Admh Division of Intellectual Disabili, Comprehensive Support Svcs Riv & V, Wetumpka, AL 36092 | 2007-02-16 |
| 1952472607 | Wetumpka Family Practice Pa | Family Medicine | 73970 Tallassee Hwy, Wetumpka, AL 36092 | 2006-11-13 |
| 1063429744 | Jim G Anderson | Chiropractor | 76299 Tallassee Hwy, Wetumpka, AL 36092 | 2006-08-02 |
| 1710908009 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 5326 Hwy 231 South, Wetumpka, AL 36092 | 2006-07-21 |
| 1629011770 | Spencer J Coleman Sr. | Family Medicine | 73970 Tallassee Highway, Wetumpka, AL 36092 | 2006-06-14 |
| Find all providers in zip 36092 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184236549 | Clinical Urology Associates, P.C. | Urology | 7063 Veterans Pkwy Ste 100, Pell City, AL 35125-5114 | 2020-08-18 |
| 1356866693 | Clinical Urology Associates, P.C. | Urology | 740 County Road 407, Centre, AL 35960-6759 | 2017-08-08 |
| 1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
| 1538587076 | Adam Seth Baumgarten | Urology | 2000 6th Ave S Fl 5, Birmingham, AL 35233-2110 | 2014-04-02 |
| 1952739484 | Limestone Urology Associates | Urology | 101 Fitness Way Ste 2300, Athens, AL 35611-2480 | 2013-10-18 |
| 1053657452 | David Mitchell Comfort | Urology | 2716 Hanover Circle, Unit 801, Birmingham, AL 35205 | 2012-12-13 |
| 1700120920 | Kirby Knapp Bryant Jr Jr. | Urology | 507 Hillyer High Rd, Anniston, AL 36207-6272 | 2012-11-15 |
| 1932451093 | Samuel Britt Owens | Urology | 2320 Brookwood Dr Se, Decatur, AL 35601-6176 | 2012-10-12 |
| 1245505536 | Urology Associates of North Alabama | Urology | 1874 Beltine Road, Sw, Suite 106, Decatur, AL 35601 | 2012-03-20 |
| 1487930749 | Sheridan William Shirley | Urology | 4072 Crossings Lane, Birmingham, AL 35242-4474 | 2011-10-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.