JACKSON HOSPITAL AND CLINIC INC (NPI# 1164803367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164803367 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC |
| Other Organization Name | JACKSON UROLOGY EAST |
| Practice Address |
226 Mitylene Park Dr Montgomery AL 36117-3548 |
| Mailing Address |
1722 Pine St Ste 503 Montgomery AL 36106-1160 |
| Practice Telephone | 3342817666 |
| Practice Fax Number | 3342936859 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | KELIN PENNEY (ADMINISTRATOR) |
| Authorized Official Telephone | 3342402337 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON HOSPITAL AND CLINIC INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Urology East | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1407387848 | Jackson Hospital and Clinic Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2017-03-27 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1891156469 | Jackson Hospital and Clinic Inc | Internal Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2016-03-10 |
| 1912362773 | Jackson Hospital and Clinic Inc | Internal Medicine | 1758 Park Pl, Suite 401, Montgomery, AL 36106-1127 | 2015-12-22 |
| 1679946610 | Jackson Hospital and Clinic Inc | Neurological Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2015-11-12 |
| 1740657683 | Jackson Hospital and Clinic Inc | Surgery | 44 Medical Arts Ct, Greenville, AL 36037-3869 | 2015-08-26 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1831513787 | Jackson Hospital and Clinic Inc | Surgery | 7201 Copperfield Dr, Montgomery, AL 36117-7101 | 2014-02-13 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| Street Address |
226 MITYLENE PARK DR |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36117-3548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831189158 | William Todd Sherrer | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2005-10-27 |
| 1932329711 | Timothy W Morrow Md PC | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061307 | Bhg Lxxiii, LLC | Clinic/Center | 1714 Platt Place, Montgomery, AL 36117 | 2020-10-22 |
| 1952945602 | East Montgomery Pediatrics LLC | Pediatrics | 337 St Lukes Drive, Montgomery, AL 36117 | 2019-11-05 |
| 1417421496 | Tiffany Webb | Specialist | 411 Twain Curve, E, Montgomey, AL 36117 | 2019-01-14 |
| 1013485374 | Montgomery Orthodontic Specialists | Dentist | 5833 Carmichael Road, Montgomery, AL 36117 | 2018-11-05 |
| 1770050791 | Blair Henderson Parks | Speech-Language Pathologist | 7088 University Court, Montgomery, AL 36117 | 2018-10-29 |
| 1629557822 | Evelyn F Crayton | Dietitian, Registered | 124 Elm Dr, Montgomery, AL 36117 | 2018-08-08 |
| 1194203414 | Coopers Mental Healh Consultations | Psychologist | 8743 Ridgestone Ct, Montgomery, AL 36117 | 2018-07-30 |
| 1063912301 | Gardenia Cove Mental Health PC | Psychiatry & Neurology | 6771 Taylor Circle, Montgomery, AL 36117 | 2018-02-13 |
| 1760900294 | Montgomery Auburn Homecare LLC | In Home Supportive Care | 2569 Bell Rd, Montgomery, AL 36117 | 2017-09-05 |
| 1336667120 | Alyssa Bryanna Swisher | Chiropractor | 2026 Berryhill Road, Montgomery, AL 36117 | 2017-09-01 |
| Find all providers in zip 36117 | ||||
| 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 |
|---|---|---|---|---|
| 1942540190 | Andrew Charles Von Eschenbach | Urology | 163 Sarasota Cir S, Montgomery, TX 77356-8406 | 2013-02-26 |
| 1497764104 | Tony E Pinson | Urology | 470 Taylor Rd Ste 201, Montgomery, AL 36117-3532 | 2006-08-05 |
| 1831189158 | William Todd Sherrer | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2005-10-27 |
| 1255764007 | Wetumpka Urology LLC | Urology | 2257 Taylor Rd, Suite 200, Montgomery, AL 36117-7790 | 2013-08-15 |
| 1013287648 | The Health Care Authority for Baptist Health, An Affiliate of Uabhs | Urology | 470 Taylor Rd, Suite 202, Montgomery, AL 36117-3563 | 2012-01-12 |
| 1760770754 | Jackson Hospital and Clinic, Inc. | Urology | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2011-07-12 |
| 1730323056 | Joshua Crocker Waits | Urology | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2009-04-30 |
| 1962667873 | Gloria Susan Massey | Urology | 2055 E South Blvd, Suite 802, Montgomery, AL 36116-2001 | 2008-07-21 |
| 1316106164 | Himanshu Aggarwal | Urology | 1722 Pine St Ste 503, Montgomery, AL 36106 | 2008-06-06 |
| 1083882096 | Geoffrey Michael Habermacher | Urology | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2454 | 2008-02-12 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36117 |
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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.