JACKSON-MADISON COUNTY GENERAL HOSPITAL (NPI# 1164786257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164786257 |
| Entity Type | Organization |
| Organization Name | JACKSON-MADISON COUNTY GENERAL HOSPITAL |
| Other Organization Name | MEDICAL CENTER EMS |
| Practice Address |
620 Skyline Dr Jackson TN 38301-3923 |
| Practice Telephone | 7315415000 |
| Practice Fax Number | 7315416802 |
| Mailing Telephone | 7315415000 |
| Mailing Fax Number | 7315416802 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2016-12-22 |
| Authorized Official Name | MR. JAMES ROSS (INTERIM PRESIDENT AND CEO) |
| Authorized Official Telephone | 7315416730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
EMS0000010066 | TN | Transportation Services |
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
EMS0000010067 | TN | Transportation Services |
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
EMS0000005702 | TN | Transportation Services |
| Other Name | Type Code |
|---|---|
| Medical Center EMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194715987 | Jackson-madison County General Hospital | Skilled Nursing Facility | 670 Skyline Dr, Jackson, TN 38301-3934 | 2005-10-24 |
| 1104816966 | Jackson-madison County General Hospital | Hospice Care, Community Based | 1804 Highway 45 Byp, Jackson, TN 38305-4436 | 2005-10-24 |
| 1366432122 | Jackson-madison County General Hospital | Home Infusion | 1061 West Forest Avenue, Jackson, TN 38301-3879 | 2005-10-24 |
| 1811039704 | Jackson-madison County General Hospital | Pharmacy | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JACKSON-MADISON COUNTY GENERAL HOSPITAL | 620 Skyline Dr, Jackson, TN 38301-3901 |
| System for Award Management (SAM) Entities | JACKSON-MADISON COUNTY GENERAL HOSPITAL DISTRICT | 620 Skyline Dr, Jackson, TN 38301-3923 |
| Street Address |
620 SKYLINE DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094608 | Julie A Mcbroom | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2005-06-25 |
| 1205440260 | Heather Middleton | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-09-06 |
| 1780297291 | Holly R Jones | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-08-25 |
| 1851909972 | Earl Wade Lomax | Student in an Organized Health Care Education/Training Program | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-07-15 |
| 1356960835 | Gregory Heath Mcneely | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-04-14 |
| 1174157515 | Matthew Lee Luttrell | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-02-25 |
| 1528698594 | Heidi Hill | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-01-18 |
| 1407406861 | Justin Harrison | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-09-18 |
| 1770131856 | Shelby Kathryn Berry | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-30 |
| 1891342028 | Jack Harold Fields IIi | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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|---|---|---|---|---|
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| 1730564436 | Jackson Township First Aid Squad Inc | Ambulance | 38 E Veterans Hwy, Jackson, NJ 08527-4519 | 2015-07-23 |
| 1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
| 1437418506 | Arrow-med Ambulance, Inc. | Ambulance | 68 Shacks Ln, Jackson, KY 41339-7603 | 2012-05-10 |
| 1457627986 | Six Flags Great Adventure LLC | Ambulance | 1 Six Flags Blvd, Jackson, NJ 08527-5369 | 2012-03-29 |
| 1851601132 | County of Jackson | Ambulance | 260 Pattonsville Rd, Jackson, OH 45640-9452 | 2010-10-20 |
| 1760635700 | Life Star Healthcare LLC | Ambulance | 111 Glendale St, Jackson, TN 38301-5101 | 2008-11-03 |
| 1003947953 | County of Teton | Ambulance | 40 E Pearl Ave, Jackson, WY 83001 | 2007-03-09 |
| 1770686610 | Village of Jackson | Ambulance | W204n16722 Jackson Dr, Jackson, WI 53037-9796 | 2006-09-06 |
| 1831206713 | Jackson Emergency Transport Service, LLC | Ambulance | 210 S Kimball Ave, Jackson, AL 36545-2726 | 2006-08-24 |
| Find all providers in JACKSON | ||||
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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.