JACKSON GASTROENTEROLOGY CENTER, LLC (NPI# 1265618904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265618904 |
Entity Type | Organization |
Organization Name | JACKSON GASTROENTEROLOGY CENTER, LLC |
Other Organization Name | EAST JACKSON CENTER |
Practice Address |
4400 Ann Arbor Road Jackson MI 49202 |
Practice Telephone | 5179900602 |
Mailing Telephone | 5179900602 |
Enumeration Date | 2008-01-11 |
Last Update Date | 2008-10-20 |
Authorized Official Name | MR. RODNEY LUNN (MEMBER) |
Authorized Official Telephone | 6154250818 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | FACILITY NUMBER | 38-6814 | 01 |
Other Name | Type Code |
---|---|
East Jackson Center | Doing Business As Name - Organization |
Street Address |
4400 ANN ARBOR ROAD |
City | JACKSON |
State | MI |
Zip Code | 49202 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
Find all providers in zip 49202 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821336371 | Eyecare Surgery Center, LLC | Clinic/Center | 1501 Lakeland Dr Ste 101, Jackson, MS 39216-4839 | 2013-01-17 |
1912099805 | Sapheneia Medical Minimally Invasive Therapy Institute | Clinic/Center | 932 N State St, Jackson, MS 39202-2613 | 2006-09-28 |
1588764989 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 1125 E Michigan Ave, Jackson, MI 49201-1801 | 2006-09-25 |
1225096498 | Amador Surgery Center | Clinic/Center | 223 Clinton Road, Suite 204, Jackson, CA 95642-2680 | 2006-05-03 |
1558327213 | Surgicare of Jackson Ltd | Clinic/Center | 760 Lakeland Dr, Jackson, MS 39216-4610 | 2006-04-21 |
1588631832 | Surgical Services of Michigan, LLC | Clinic/Center | 2775 Blake Road, Jackson, MI 49201-8838 | 2006-03-07 |
1255303517 | St Dominic Ambulatory Surgery Center L L C | Clinic/Center | 970 Lakeland Dr, Suite 15, Jackson, MS 39216-4601 | 2006-02-02 |
1689651481 | Teton Outpatient Services LLC | Clinic/Center | 150 Buffalo Way, Jackson, WY 83001-2530 | 2005-12-22 |
1710591060 | Midsouth Interventional Pain Institute LLC | Clinic/Center | 2016 Greystone Sq, Jackson, TN 38305-3575 | 2020-09-03 |
1386149979 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 205 S East Ave, Jackson, MI 49201-2413 | 2018-03-27 |
Find all providers in JACKSON |
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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.