JACKSON HOSPITAL & CLINIC, INC. (NPI# 1013433820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013433820 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL & CLINIC, INC. |
| Other Organization Name | JACKSON CLINIC UROLOGY TALLASSEE |
| Practice Address |
80 Herren Hill Rd Ste C Tallassee AL 36078-1264 |
| Mailing Address |
1722 Pine St Ste 503 Montgomery AL 36106-1160 |
| Practice Telephone | 3342938588 |
| Practice Fax Number | 3342936978 |
| Mailing Telephone | 3342938736 |
| Mailing Fax Number | 3342938738 |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | TARA HERRING (REVENUE CYCLE DIRECTOR) |
| Authorized Official Telephone | 3342402337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Urology Tallassee | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316447063 | Jackson Hospital & Clinic, Inc. | Internal Medicine | 1722 Pine St Ste 406, Montgomery, AL 36106-1159 | 2018-02-20 |
| 1235667544 | Jackson Hospital & Clinic, Inc. | Obstetrics & Gynecology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-05-31 |
| 1720599012 | Jackson Hospital & Clinic, Inc. | Otolaryngology | 1111 Olive St, Montgomery, AL 36106-1129 | 2017-10-13 |
| 1245750660 | Jackson Hospital & Clinic, Inc. | Family Medicine | 4150 Carmichael Rd Ste B, Montgomery, AL 36106-2933 | 2017-06-27 |
| 1215464300 | Jackson Hospital & Clinic, Inc. | Surgery | 1801 Pine St Ste 101, Montgomery, AL 36106-1154 | 2017-05-19 |
| 1730597816 | Jackson Hospital & Clinic, Inc. | Psychiatric Unit | 1725 Pine St, Montgomery, AL 36106-1109 | 2014-08-01 |
| Street Address |
80 HERREN HILL RD STE C |
| City | TALLASSEE |
| State | AL |
| Zip Code | 36078-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235667544 | Jackson Hospital & Clinic, Inc. | Obstetrics & Gynecology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811286321 | Kenneth Wesley Atkins | Behavioral Analyst | 101 S Dubois, Tallassee, AL 36078 | 2011-04-05 |
| 1811089030 | Shawn Keahey | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1952409088 | Randal David Herring | Chiropractor | 315 Friendship Road, Tallassee, AL 36078 | 2006-09-20 |
| 1609801133 | Alexander Robbins | Surgery | 875 Friendship Road, Cmac Suite F, Tallassee, AL 36078 | 2006-07-12 |
| 1063467447 | John H Rand | Otolaryngology | 80 Herren Hill Road, Ste D, Tallassee, AL 36078 | 2006-05-23 |
| 1073067856 | Deray Junior Williams | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078 | 2016-08-09 |
| 1881752996 | Charles D Mccartha | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-12-04 |
| 1013009315 | Tallassee Family Dentistry PCc | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1538191648 | Tom Crain | Physical Therapist | 1000 Friendship Rd, Tallassee, AL 36078 | 2006-07-07 |
| 1417412081 | Collin Jones | Specialist/Technologist | 213 Godwin Rd, Tallassee, AL 36078-1129 | 2019-02-07 |
| Find all providers in zip 36078 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184236549 | Clinical Urology Associates, P.C. | Urology | 7063 Veterans Pkwy Ste 100, Pell City, AL 35125-5114 | 2020-08-18 |
| 1356866693 | Clinical Urology Associates, P.C. | Urology | 740 County Road 407, Centre, AL 35960-6759 | 2017-08-08 |
| 1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
| 1538587076 | Adam Seth Baumgarten | Urology | 2000 6th Ave S Fl 5, Birmingham, AL 35233-2110 | 2014-04-02 |
| 1952739484 | Limestone Urology Associates | Urology | 101 Fitness Way Ste 2300, Athens, AL 35611-2480 | 2013-10-18 |
| 1053657452 | David Mitchell Comfort | Urology | 2716 Hanover Circle, Unit 801, Birmingham, AL 35205 | 2012-12-13 |
| 1700120920 | Kirby Knapp Bryant Jr Jr. | Urology | 507 Hillyer High Rd, Anniston, AL 36207-6272 | 2012-11-15 |
| 1932451093 | Samuel Britt Owens | Urology | 2320 Brookwood Dr Se, Decatur, AL 35601-6176 | 2012-10-12 |
| 1245505536 | Urology Associates of North Alabama | Urology | 1874 Beltine Road, Sw, Suite 106, Decatur, AL 35601 | 2012-03-20 |
| 1487930749 | Sheridan William Shirley | Urology | 4072 Crossings Lane, Birmingham, AL 35242-4474 | 2011-10-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JACKSON HOSPITAL & CLINIC, INC..
| 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.