JACKSON HOSPITAL AND CLINIC, INC (NPI# 1659879633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659879633 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC, INC |
| Other Organization Name | JACKSON CLINIC GASTROENTEROLOGY PRATTVILLE |
| Practice Address |
707 Mcqueen Smith Rd S Prattville AL 36066-7503 |
| 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 | 2018-01-25 |
| Last Update Date | 2018-01-25 |
| Authorized Official Name | KELIN PENNEY (ADMINISTRATOR) |
| Authorized Official Telephone | 3342402335 |
| 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 Gastroenterology Prattville | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528699444 | Jackson Hospital and Clinic, Inc | Specialist | 321 Greenville Byp Ste 2, Greenville, AL 36037-3757 | 2020-01-29 |
| 1770944340 | Jackson Hospital and Clinic, Inc | Internal Medicine | 74238 Tallassee Hwy, Wetumpka, AL 36092-5504 | 2016-03-10 |
| 1306447958 | Jackson Hospital and Clinic, Inc | Colon & Rectal Surgery | 1722 Pine St Ste 402, Montgomery, AL 36106-1159 | 2020-11-02 |
| 1497362172 | Jackson Hospital and Clinic, Inc | Family Medicine | 4035 Atlanta Hwy, Montgomery, AL 36109-2920 | 2020-09-28 |
| 1861827297 | Jackson Hospital and Clinic, Inc | Family Medicine | 11123 Chantilly Pkwy Ct, Ste M, Pike Road, AL 36064-2880 | 2013-09-04 |
| 1639314230 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2008-12-10 |
| 1114082393 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1801 Pine St, Suite 302, Montgomery, AL 36106-1154 | 2006-12-27 |
| 1093870339 | Jackson Hospital and Clinic, Inc | Family Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2006-12-27 |
| 1104981380 | Jackson Hospital and Clinic, Inc | Family Medicine | 1801 Pine St, Suite 204, Montgomery, AL 36106-0165 | 2006-12-27 |
| 1376568964 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1725 Pine St, Montgomery, AL 36106-1109 | 2006-07-13 |
| Street Address |
707 MCQUEEN SMITH RD S |
| City | PRATTVILLE |
| State | AL |
| Zip Code | 36066-7503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053856591 | Camellia Hospice of South Alabama, LLC | Hospice Care, Community Based | 1807 Station Dr Ste B, Prattville, AL 36066 | 2016-12-19 |
| 1265805550 | Alabama Dental Professionals, PC | Dentist | 2489 Cobbs Ford Road, Prattville, AL 36066 | 2015-11-09 |
| 1407243645 | Drayer Physical Therapy-alabama, LLC | Physical Therapist | 2703 Legends Parkway, Prattville, AL 36066 | 2015-04-24 |
| 1225396203 | Kristin Taylor | Occupational Therapist | 635 Mcqueen Smith Road, Suite D, Prattville, AL 36066 | 2012-04-27 |
| 1164796959 | Glynwood Park Dental Care | Dentist | 1831 Glynwood Drive, Prattville, AL 36066 | 2012-02-27 |
| 1790068757 | Jason Duane Weaver | Physical Therapist | 1824 Glynwood Drive, Prattville, AL 36066 | 2011-09-26 |
| 1982931499 | Health Star Inc | Chiropractor | 2441 Cobbs Ford Road, Prattville, AL 36066 | 2009-11-05 |
| 1023101698 | Drs. Tatum and Walker, L.L.C. | Dentist | 597 South Memorial Drive, Prattville, AL 36066 | 2006-10-02 |
| 1730290693 | Shalini Goswami | Internal Medicine | 1294 E Main St, Prattville, AL 36066 | 2006-08-31 |
| 1407860380 | Robert Allen Avery | Internal Medicine | 645 Mcqueen Smith Rd N Ste 207, Prattville, AL 36066 | 2006-07-28 |
| Find all providers in zip 36066 | ||||
| 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 |
|---|---|---|---|---|
| 1316447063 | Jackson Hospital & Clinic, Inc. | Internal Medicine | 1722 Pine St Ste 406, Montgomery, AL 36106-1159 | 2018-02-20 |
| 1760998223 | Marshall Medical Center South Medical Specialists of North Alabama | Internal Medicine | 55 Rowe Dr Ste C, Guntersville, AL 35976-7366 | 2017-12-20 |
| 1962862078 | University of South Alabama | Internal Medicine | 75 S University Blvd Ucom 6000 B, Mobile, AL 36688-0002 | 2016-03-02 |
| 1730579707 | Jerome Gaeton Ippolito | Internal Medicine | 4412 Fredricksburg Drive, Birmingham, AL 35213 | 2015-01-29 |
| 1629408083 | Digestive Disease Associates PC | Internal Medicine | 451 Saint Lukes Dr, Montgomery, AL 36117-7107 | 2013-11-22 |
| 1588913867 | Muhammad Ali Khan | Internal Medicine | 1720 2nd Ave S # Bdb380, Birmingham, AL 35294 | 2012-09-03 |
| 1417204686 | Wilhelm Tietke Md PC | Internal Medicine | 131 Longwood Dr Sw, Huntsville, AL 35801-4522 | 2012-08-07 |
| 1851646889 | Lewis Wayne Pressgrove Sr. | Internal Medicine | 2547 Ashford Pl, Birmingham, AL 35243-2244 | 2012-07-16 |
| 1669762480 | Riverside Gastroenterology PC | Internal Medicine | 1304 Somerville Rd Se, Decatur, AL 35601-4354 | 2011-04-13 |
| 1093942880 | William A Webb | Internal Medicine | 2214 Watercrest Dr, Auburn, AL 36830-4117 | 2009-06-18 |
| Find all providers with the same taxonomy | ||||
| City | PRATTVILLE |
| Zip Code | 36066 |
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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.