JACKSON COUNTY HOSPITAL DISTRICT (NPI# 1457432460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457432460 |
| Entity Type | Organization |
| Organization Name | JACKSON COUNTY HOSPITAL DISTRICT |
| Other Organization Name | JACKSON MEDICAL CLINIC PHYSICAN GROUP |
| Practice Address |
1013 S Wells St Edna TX 77957-4098 |
| Practice Telephone | 3617827800 |
| Practice Fax Number | 3617827495 |
| Mailing Telephone | 3617827800 |
| Mailing Fax Number | 3617827495 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2009-10-15 |
| Authorized Official Name | ASA B WILSON (ADMINSITRATOR/CEO) |
| Authorized Official Telephone | 3617827810 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 111714501 | 05 | |
| TX | BLUE CROSS | 00U54J | 01 |
| Other Name | Type Code |
|---|---|
| Jackson Medical Clinic Physican Group | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841371739 | Jackson County Hospital District | Medicare Defined Swing Bed Unit | 1013 S Wells Street, Edna, TX 77957-4098 | 2006-10-18 |
| 1407892698 | Jackson County Hospital District | Skilled Nursing Facility | 107 E Rogers, Ganado, TX 77962-1204 | 2006-06-22 |
| 1215971478 | Jackson County Hospital District | Emergency Medicine | 1013 S. Wells Street, Edna, TX 77957-4098 | 2006-06-16 |
| 1285677401 | Jackson County Hospital District | Home Health | 918 South Wells Street, Edna, TX 77957-3745 | 2006-06-14 |
| 1346283033 | Jackson County Hospital District | Clinic/Center | 202 S Third Street, Ganado, TX 77962-1214 | 2006-06-13 |
| 1124061882 | Jackson County Hospital District | General Acute Care Hospital | 1013 South Wells Street, Edna, TX 77957-4098 | 2006-06-13 |
| 1992748693 | Jackson County Hospital District | Clinic/Center | 1013a South Wells Street, Edna, TX 77957-4045 | 2006-06-13 |
| 1083035232 | Jackson County Hospital District | Clinic/Center | 4318 5th Ave, Marianna, FL 32446-2182 | 2013-12-13 |
| 1710261573 | Jackson County Hospital District | Ambulance | 1013 S Wells St, Edna, TX 77957-4045 | 2011-09-28 |
| 1881815520 | Jackson County Hospital District | Specialist | 3051 6th St, Marianna, FL 32446-1933 | 2007-05-01 |
| Street Address |
1013 S WELLS ST |
| City | EDNA |
| State | TX |
| Zip Code | 77957-4098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487280319 | Wendi Nicole Priesmeyer | Social Worker | 1013 S Wells St, Edna, TX 77957-4045 | 2020-03-23 |
| 1457881591 | Lori Lea Karl | Nurse Practitioner | 1013 S Wells St, Edna, TX 77957-4045 | 2017-06-12 |
| 1689020992 | Molly Breanne Quinn-frankel | Family Medicine | 1013 S Wells St, Edna, TX 77957-4045 | 2016-05-05 |
| 1811372501 | Bruce W Rogers | Pharmacy | 1013 S Wells St, Bldg B, Edna, TX 77957-4045 | 2015-07-23 |
| 1376942318 | Stephanie Cunningham | Nurse Practitioner | 1013 S Wells St, Edna, TX 77957-4045 | 2014-08-15 |
| 1184970816 | Martha Avila-adame | Nurse Practitioner | 1013 S Wells St, Edna, TX 77957-4045 | 2012-07-31 |
| 1710261573 | Jackson County Hospital District | Ambulance | 1013 S Wells St, Edna, TX 77957-4045 | 2011-09-28 |
| 1295975548 | Kara Nicole Mccain | Physical Therapist | 1013 S Wells St, Attn: Physical Therapy Dept, Edna, TX 77957-4045 | 2009-02-26 |
| 1730359456 | Select Physical Therapy Holdings Inc | Clinic/Center | 1013 S Wells St, Edna, TX 77957-4045 | 2008-03-10 |
| 1245422096 | Robert W. Farris Jr. | Nurse Practitioner | 1013 S Wells St, Edna, TX 77957-4045 | 2007-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043399330 | Mchenry Lee | Dentist | 118 N Wells St, Edna, TX 77957 | 2006-11-06 |
| 1740377522 | Travis R Phillips | Dentist | 502 North Wells, Edna, TX 77957 | 2006-10-05 |
| 1952417123 | Dawn Rachelle Jalufka | Optometrist | 201 N Wells, Enda, TX 77957 | 2006-08-21 |
| 1033699699 | Kimberly Alvarado | Occupational Therapy Assistant | 1401 W Main St, Edna, TX 77957 | 2018-08-14 |
| 1255468948 | Jackson County Special Services Coop | Local Education Agency (LEA) | 606 Gilbert Street, Edna, TX 77957-0919 | 2007-02-28 |
| 1760455158 | Fmsc Edna Operating Company Lp | Skilled Nursing Facility | 1204 N Wells St, Edna, TX 77957-2149 | 2006-02-08 |
| 1063558526 | Care Inn of Edna LLC | Skilled Nursing Facility | 1204 N Wells St, Edna, TX 77957-2149 | 2007-01-30 |
| 1245760784 | Emilie Faucheu | Dentist | 1006 N Wells St, Edna, TX 77957-2153 | 2017-06-18 |
| 1801813076 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 1002 N Wells St, Edna, TX 77957-2153 | 2006-07-16 |
| 1558317172 | Total Renal Care Texas Limited Partnership | Clinic/Center | 1008 N Wells St, Edna, TX 77957-2153 | 2006-05-25 |
| Find all providers in zip 77957 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578526992 | Jefferson Mcdowell Flowers, Jr. | General Practice | 1013 S Wells St, Edna, TX 77957-4045 | 2006-04-07 |
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| 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.