JACKSON HOSPITAL AND CLINIC INC (NPI# 1912362773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912362773 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC |
| Other Organization Name | JACKSON CLINIC CARDIOLOGY |
| Practice Address |
1758 Park Pl Suite 401 Montgomery AL 36106-1127 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342649191 |
| Practice Fax Number | 3342649821 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2015-12-22 |
| 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 |
|---|---|---|---|---|
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1407387848 | Jackson Hospital and Clinic Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2017-03-27 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1891156469 | Jackson Hospital and Clinic Inc | Internal Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2016-03-10 |
| 1679946610 | Jackson Hospital and Clinic Inc | Neurological Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2015-11-12 |
| 1740657683 | Jackson Hospital and Clinic Inc | Surgery | 44 Medical Arts Ct, Greenville, AL 36037-3869 | 2015-08-26 |
| 1164803367 | Jackson Hospital and Clinic Inc | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2015-06-12 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1831513787 | Jackson Hospital and Clinic Inc | Surgery | 7201 Copperfield Dr, Montgomery, AL 36117-7101 | 2014-02-13 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| Street Address |
1758 PARK PL SUITE 401 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699765271 | Howard L Brazil | Specialist | 1758 Park Pl, Montgomery, AL 36106-1133 | 2005-10-25 |
| 1407387848 | Jackson Hospital and Clinic Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2017-03-27 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1528475084 | William Saliski | Nurse Practitioner | 1758 Park Pl, Ste 300, Montgomery, AL 36106-1127 | 2014-07-16 |
| 1093068900 | Stewart H Tankersley, Md, LLC | Clinic/Center | 1758 Park Pl, Suite 200, Montgomery, AL 36106-1127 | 2012-10-17 |
| 1841576915 | Shelley Sanders Byrd | Nurse Practitioner | 1758 Park Pl, Suite 100, Montgomery, AL 36106-1127 | 2011-11-02 |
| 1346566700 | Latoya Shantel Clark | Obstetrics & Gynecology | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2010-04-09 |
| 1013140904 | Southeast Cancer Network, Inc | Internal Medicine | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2009-08-26 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1487978466 | William U Cawthon | Internal Medicine | 2221 Green Park Dr, Montgomery, AL 36111-1605 | 2010-03-20 |
| 1174639611 | Richard Dale Arnott | Internal Medicine | 205 Perry Hill Rd, Montgomery, AL 36109-3725 | 2006-08-21 |
| 1568492544 | Tamjeed Arshad | Internal Medicine | 2055 East South Blvd, Suite 403, Montgomery, AL 36116 | 2006-07-04 |
| 1326047416 | Dilip C. Patel | Internal Medicine | 2055 E South Blvd., Suite 403, Montgomery, AL 36116 | 2005-07-20 |
| 1356346852 | Scott W. Sims | Internal Medicine | 273 Winton M Blount Loop, Montgomery, AL 36117-3507 | 2005-06-20 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1053766923 | Oa Rwb LLC | Internal Medicine | 7104 University Ct, Suite B, Montgomery, AL 36117-8045 | 2016-04-28 |
| 1639458987 | Pooja Sethi | Internal Medicine | 4371 Narrow Lane Rd, Montgomery, AL 36116-2971 | 2011-08-04 |
| 1154646966 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1725 Pine St, Montgomery, AL 36106-1109 | 2010-04-05 |
| 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.