JACKSON HOSPITAL & CLINIC, INC. (NPI# 1316447063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316447063 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL & CLINIC, INC. |
| Other Organization Name | JACKSON CLINIC GASTRO STE 406 |
| Practice Address |
1722 Pine St Ste 406 Montgomery AL 36106-1159 |
| Mailing Address |
1722 Pine St Ste 503 Montgomery AL 36106-1160 |
| Practice Telephone | 3342936825 |
| Practice Fax Number | 3342936826 |
| Mailing Telephone | 3342938736 |
| Mailing Fax Number | 3342938738 |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-06-16 |
| 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 | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Gastro Ste 406 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235667544 | Jackson Hospital & Clinic, Inc. | Obstetrics & Gynecology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-05-31 |
| 1720599012 | Jackson Hospital & Clinic, Inc. | Otolaryngology | 1111 Olive St, Montgomery, AL 36106-1129 | 2017-10-13 |
| 1013433820 | Jackson Hospital & Clinic, Inc. | Urology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-08-15 |
| 1245750660 | Jackson Hospital & Clinic, Inc. | Family Medicine | 4150 Carmichael Rd Ste B, Montgomery, AL 36106-2933 | 2017-06-27 |
| 1215464300 | Jackson Hospital & Clinic, Inc. | Surgery | 1801 Pine St Ste 101, Montgomery, AL 36106-1154 | 2017-05-19 |
| 1730597816 | Jackson Hospital & Clinic, Inc. | Psychiatric Unit | 1725 Pine St, Montgomery, AL 36106-1109 | 2014-08-01 |
| Street Address |
1722 PINE ST STE 406 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1159 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629408083 | Digestive Disease Associates PC | Internal Medicine | 451 Saint Lukes Dr, Montgomery, AL 36117-7107 | 2013-11-22 |
| 1487741237 | Robert Randolph Brinson | Internal Medicine | 7080 Sydney Curv, Montgomery, AL 36117-3508 | 2006-10-05 |
| 1417994179 | Joseph Wellington Jackson | Internal Medicine | 1501 Forest Ave, Montgomery, AL 36106-1539 | 2006-06-01 |
| 1043274830 | Mohamad Riad Sankari | Internal Medicine | 400 6th Ave, Montgomery, WV 25136-2117 | 2006-04-17 |
| 1962475020 | William Penn White IIi | Internal Medicine | 4126 Carmichael Ct, Montgomery, AL 36106-2871 | 2006-02-09 |
| 1689661860 | Richard Ginsburg | Internal Medicine | 4146 Carmichael Rd Ste B, Montgomery, AL 36106-3634 | 2005-10-03 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1306070818 | Heather Echols | Internal Medicine | 4126 Carmichael Ct, Montgomery, AL 36106-2871 | 2009-05-12 |
| 1114176419 | Pranav Babulal Patel | Internal Medicine | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2454 | 2008-09-11 |
| 1174785562 | Viplove Senadhi | Internal Medicine | 1722 Pine St, Suite 801, Montgomery, AL 36106-1103 | 2008-06-27 |
| 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.