QHG OF JACKSONVILLE INC (NPI# 1457458820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457458820 |
| Entity Type | Organization |
| Organization Name | QHG OF JACKSONVILLE INC |
| Other Organization Name | JACKSONVILLE MEDICAL CENTER |
| Practice Address |
1701 Pelham Rd S Jacksonville AL 36265-3353 |
| Mailing Address |
7100 Commerce Way Suite 180 Brentwood TN 37027-2829 |
| Practice Telephone | 2564354970 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | Y |
| Parent Organization Name | QHG OF JACKSONVILLE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jacksonville Medical Center | Doing Business As Name - Organization |
| Street Address |
1701 PELHAM RD S |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-3353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508824764 | William Ernest Tyndall | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2006-05-03 |
| 1679011969 | Jacksonville Internal Medicine & Wellness LLC | Legal Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2017-02-07 |
| 1427503010 | The Health Care Authority of The City of Anniston | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2016-08-24 |
| 1982058392 | Christina Joy Latta | Nurse Practitioner | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2016-04-21 |
| 1316312028 | Jacksonville Aristo Er, LLC | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3353 | 2015-12-07 |
| 1235575622 | Stoney Brook Emergency Physicians, Pllc | Emergency Medicine | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2013-05-13 |
| 1285971895 | Timothy B Tabor Md PC | Radiology | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2013-01-16 |
| 1942506852 | Physician Services of Alabama LLC | Specialist | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2011-02-10 |
| 1285945832 | Wade Bilger | Nurse Anesthetist, Certified Registered | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2010-06-29 |
| 1205165065 | Jacksonville Anesthesia LLC | Anesthesiology | 1701 Pelham Rd S, Jacksonville, AL 36265-3369 | 2009-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203451 | Brittany Clark | Anesthesiology | 220 Riverside Ave Unit 328, Jacksonville, FL 32202-4953 | 2019-09-11 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1699223453 | James Dennis Beeson | Anesthesiology | 9289 Rosewater Lane, Jacksonville, FL 32256 | 2016-09-21 |
| 1598129314 | Kaitlin Kamrowski | Anesthesiology | 653 West 8th Street, Faculty Clinic Building, 3rd Floor, Box Fc-12, Jacksonville, FL 32209 | 2016-04-07 |
| 1487017786 | Guy Kositratna | Anesthesiology | 653 West 8th Street, Jacksonville, FL 32209-6511 | 2016-04-04 |
| 1942603899 | Pain Medicine Physicians of Jacksonville, LLC | Anesthesiology | 10250 Normandy Boulevard, Suite 702, Jacksonville, FL 32221 | 2014-10-07 |
| 1063707784 | Chase Alan Kissling | Anesthesiology | Attn: Dmhrsi Team Bldg H 2005 Knight Lane, Navy Medicine Support Command, Jacksonville, FL 32212-0140 | 2011-06-10 |
| 1770804916 | Michael George Zakaroff | Anesthesiology | 2005 Knight Lane Bldh H, Navy Medicine Support Command Attn: Medical Staff Servi, Jacksonville, FL 32212-0140 | 2010-06-22 |
| 1427283522 | Darryl Crosswright Hall | Anesthesiology | 653 W. Eighth St., Faculty Clinic 3rd Floor, Jacksonville, FL 32209 | 2009-05-19 |
| 1578707071 | Puja Roy | Anesthesiology | 8268 Ashworth Ct, Jacksonville, FL 32256-3638 | 2009-04-28 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
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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.