JACKSON HOSPITAL AND CLINIC INC. (NPI# 1194256438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194256438 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC. |
| Other Organization Name | JACKSON GENERAL SURGERY |
| Practice Address |
1722 Pine St Ste 201 Montgomery AL 36106-1158 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342648741 |
| Practice Fax Number | 3342642216 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-01-30 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson General Surgery | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1722 Pine St Ste 503, Montgomery, AL 36106 | 3342648741 | 3342642216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053844654 | Jackson Hospital and Clinic Inc. | Urology | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 | 2017-04-10 |
| 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 |
1722 PINE ST STE 201 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747205 | Rural Urgent Care LLC | Clinic/Center | 3039 Vaughn Road, Montgomery, AL 36106 | 2020-07-16 |
| 1548733306 | Bennett Family Dentistry, LLC | Dentist | 4270 Carmichael Road, Montgomery, AL 36106 | 2019-01-04 |
| 1588133854 | Lori Leanne Fail | Physical Therapist | 1615 Windsor Hill Court, Montgomery, AL 36106 | 2018-11-16 |
| 1073020749 | Charlene Richmond Harrell | Chiropractor | 2900 Zelda Rd., Suite A, Montgomery, AL 36106 | 2018-01-03 |
| 1780123109 | Montgomery Accident and Injury Center, Inc | Nurse Practitioner | 2900 Zelda Rd, Ste B, Montgomery, AL 36106 | 2017-02-17 |
| 1467843573 | Ernest Porterfield | Non-emergency Medical Transport (VAN) | 4183 Carmichael Road, Suite A, Montgomery, AL 36106 | 2015-02-11 |
| 1114334281 | Daniel Gerald O'bryant | Specialist/Technologist | 1160 Navarro Avenue, Montgomery, AL 36106 | 2014-07-21 |
| 1801213764 | Amanda Hodge | Specialist/Technologist | 4605 Cherry Tree Terrace, Montgomery, AL 36106 | 2014-03-27 |
| 1871861542 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1758 Park Pl Ste 102, Montgomery, AL 36106 | 2011-12-08 |
| 1578862546 | Helping Hands Preventitive Health Center | Community/Behavioral Health | 2015 Mulberry St, Montgomery, AL 36106 | 2011-03-16 |
| Find all providers in zip 36106 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245641711 | Amy Elizabeth Murphy | Surgery | 10506 Montgomery Rd Ste 101, Montgomery, OH 45242-4400 | 2014-05-18 |
| 1326376922 | James W. Jones | Surgery | 31 La Costa Dr, Montgomery, TX 77356-5325 | 2009-11-20 |
| 1558535096 | Robert B Harris Md PC | Surgery | 1801 Pine Street, Suite 202, Montgomery, AL 36106-1154 | 2008-04-16 |
| 1477730026 | William C Streetman | Surgery | 470 Taylor Road, Suite 202, Montgomery, AL 36117-3532 | 2008-01-25 |
| 1790806578 | Benjamin Terrell Rush | Surgery | 2055 E South Blvd Ste 908, Montgomery, AL 36116-2007 | 2007-04-02 |
| 1780733220 | Randal M Sedlak | Surgery | 1722 Pine St Ste 503, Montgomery, AL 36106-1160 | 2007-01-10 |
| 1669568838 | Southeast Surgery, PC | Surgery | 4224 Carmichael Ct N, Montgomery, AL 36106-3621 | 2006-10-05 |
| 1669573465 | Bennie R Hamner | Surgery | 2027 Normandie Drive, Montgomery, AL 36111 | 2006-09-26 |
| 1316043037 | Alan Joseph Berlin | Surgery | 214 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2006-09-16 |
| 1245258987 | Barbara Sharon Murray | Surgery | 2167 Normandie Dr, Montgomery, AL 36111-2728 | 2006-07-18 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36106 |
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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.