JACKSON HOSPITAL AND CLINIC, INC (NPI# 1770944340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770944340 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC, INC |
| Other Organization Name | JACKSON CLINIC CARDIOLOGY |
| Practice Address |
74238 Tallassee Hwy Wetumpka AL 36092-5504 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342649191 |
| Practice Fax Number | 3342649199 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-03-10 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Cardiology | Doing Business As Name - 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 |
| 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 |
| 1659879633 | Jackson Hospital and Clinic, Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2018-01-25 |
| 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 |
74238 TALLASSEE HWY |
| City | WETUMPKA |
| State | AL |
| Zip Code | 36092-5504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195525 | River Region Family Medicine, LLC | Family Medicine | 277 Huntress Street, Suite 100, Wetumpka, AL 36092 | 2020-02-07 |
| 1710548003 | 2la, LLC | Hearing Instrument Specialist | 4354 Us Highway 231, Suite A, Wetumpka, AL 36092 | 2019-06-26 |
| 1124549308 | Medi - Rides Transport LLC | Non-emergency Medical Transport (VAN) | 173 Hill Street, Suite 103, Wetumpka, AL 36092 | 2017-06-28 |
| 1538699129 | Joni Smart | Pharmacist | 4538 Us Hwy 231, Wetumpka, AL 36092 | 2017-06-15 |
| 1134396898 | Blue Ridge Chiropractic, LLC | Chiropractor | 2412 Us Hwy 231, Wetumpka, AL 36092 | 2008-05-13 |
| 1932243565 | Patricia Dianne White Mcclanahan | Psychologist | 8476 U S Hwy 231 Admh Division of Intellectual Disabili, Comprehensive Support Svcs Riv & V, Wetumpka, AL 36092 | 2007-02-16 |
| 1952472607 | Wetumpka Family Practice Pa | Family Medicine | 73970 Tallassee Hwy, Wetumpka, AL 36092 | 2006-11-13 |
| 1063429744 | Jim G Anderson | Chiropractor | 76299 Tallassee Hwy, Wetumpka, AL 36092 | 2006-08-02 |
| 1710908009 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 5326 Hwy 231 South, Wetumpka, AL 36092 | 2006-07-21 |
| 1629011770 | Spencer J Coleman Sr. | Family Medicine | 73970 Tallassee Highway, Wetumpka, AL 36092 | 2006-06-14 |
| Find all providers in zip 36092 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1124674098 | Jamie Torres | Internal Medicine | 1118 Ross Clark Cir Ste 403, Dothan, AL 36301-3038 | 2019-08-15 |
| 1770040255 | Druid City Vascular, P.C. | Internal Medicine | 701 University Blvd E Ste 608, Tuscaloosa, AL 35401-7411 | 2019-02-21 |
| 1962933796 | Robert Derenbecker | Internal Medicine | 1808 7th Avenue South Bdb 201, Birmingham, AL 35294-0010 | 2017-03-23 |
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1053791764 | Multi-specialty Care-cardiac Care In South, LLC | Internal Medicine | 4490 Al Highway 22, Valley Grande, AL 36701-0501 | 2015-06-08 |
| 1922497312 | Michael Mckinney Cardiology PC | Internal Medicine | 1110 Lakeview Cres, Birmingham, AL 35205-1119 | 2015-01-22 |
| 1194160580 | David Huntsman Jackson | Internal Medicine | 3647 Dunbarton Dr, Mountain Brk, AL 35223-2891 | 2013-04-30 |
| 1700136728 | Farnoosh Rahimi | Internal Medicine | 2451 Fillingim St Bldg C, Mobile, AL 36617 | 2012-09-17 |
| 1720333867 | Rayan Saab | Internal Medicine | 801 Princeton Ave Sw Ste 707, Birmingham, AL 35211-1395 | 2012-07-15 |
| 1003187642 | Anand Shanker Balachandran | Internal Medicine | 333 Whitesport Dr Sw Ste 304, Huntsville, AL 35801-3455 | 2012-01-12 |
| 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.