JACKSON MADISON COUNTY GENERAL HOSPITAL (NPI# 1225029390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225029390 |
| Entity Type | Organization |
| Organization Name | JACKSON MADISON COUNTY GENERAL HOSPITAL |
| Other Organization Name | WEST TENNESSEE REHABILITATION CENTER |
| Practice Address |
620 Skyline Drive Jackson TN 38301-3901 |
| Practice Telephone | 7315416930 |
| Practice Fax Number | 7315416218 |
| Mailing Telephone | 7315416930 |
| Mailing Fax Number | 7315416218 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2016-04-29 |
| Authorized Official Name | MR. JAMES ROSS (INTERIM PRESIDENT AND CEO) |
| Authorized Official Telephone | 7315415000 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON MADISON COUNTY GENERAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | 0000000078 | TN | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 044T002 | 05 |
| Other Name | Type Code |
|---|---|
| West Tennessee Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003831785 | Jackson Madison County General Hospital | Advanced Practice Midwife | 779 W Forest Ave, Jackson, TN 38301-3943 | 2006-07-13 |
| 1396770442 | Jackson Madison County General Hospital | Advanced Practice Midwife | 110 E Forest Ave, Jackson, TN 38301-4124 | 2006-07-11 |
| 1205265485 | Jackson Madison County General Hospital | Durable Medical Equipment & Medical Supplies | 720 W Forest Ave, Jackson, TN 38301-3904 | 2013-11-07 |
| 1255547980 | Jackson Madison County General Hospital | Internal Medicine | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-05-16 |
| 1609082338 | Jackson Madison County General Hospital | Internal Medicine | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-05-16 |
| 1073683884 | Jackson Madison County General Hospital | Pharmacy | 655 Lexington Ave, Jackson, TN 38301-5075 | 2006-11-09 |
| 1437174216 | Jackson Madison County General Hospital | Pathology | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| 1750306437 | Jackson Madison County General Hospital | General Acute Care Hospital | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| 1184649865 | Jackson Madison County General Hospital | Rehabilitation Unit | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| 1992720676 | Jackson Madison County General Hospital | General Acute Care Hospital | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| Street Address |
620 SKYLINE DRIVE |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497143648 | Eleanor Freeman | Licensed Practical Nurse | 620 Skyline Drive, Jackson, TN 38302 | 2014-12-22 |
| 1063756922 | Twonia Michelle Goyer | Nurse Practitioner | 620 Skyline Drive, Jackson, TN 38301-3901 | 2012-11-15 |
| 1306197348 | Jason Clark | Nurse Anesthetist, Certified Registered | 620 Skyline Drive, Jackson, TN 38301 | 2012-10-01 |
| 1689923401 | Amy Sanders | Nurse Anesthetist, Certified Registered | 620 Skyline Drive, Jackson, TN 38301 | 2012-09-07 |
| 1316254709 | Anita L Wynn | Registered Nurse | 620 Skyline Drive, Jackson, TN 38301 | 2010-09-07 |
| 1437288016 | Jeremiah Holman Wright | Radiology | 620 Skyline Drive, Jackson, TN 38301-3901 | 2007-03-02 |
| 1720160708 | Jackson-madison County General Hospital District | Clinical Medical Laboratory | 620 Skyline Drive, Jackson, TN 38301-3901 | 2006-10-19 |
| 1518909456 | Gregory Michael Galdino | Radiology | 620 Skyline Drive, Jackson, TN 38301-3901 | 2006-06-12 |
| 1043287220 | Matthew Timothy Graham | Radiology | 620 Skyline Drive, Jackson, TN 38301-3901 | 2006-03-07 |
| 1275500597 | James Lee Ellis | Radiology | 620 Skyline Drive, Jackson, TN 38301 | 2006-03-06 |
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| 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 | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942359765 | Mississippi Methodist Hospital & Rehabilitation Center, Inc. | Rehabilitation Unit | 1350 E Woodrow Wilson Ave, Jackson, MS 39216-5112 | 2007-01-10 |
| 1144392028 | Comprehensive Rehabilitarian Centers Inc | Rehabilitation Unit | 216 W Morrell St, Suite 200, Jackson, MI 49203 | 2006-11-15 |
| 1184649865 | Jackson Madison County General Hospital | Rehabilitation Unit | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| 1942225727 | Jackson Madison County General Hospital | Rehabilitation Unit | 620 Skyline Dr, Jackson, TN 38301-3923 | 2006-07-13 |
| 1699761064 | State of Mississippi - University of Mississippi Medical Center | Rehabilitation Unit | 2500 N State St, Jackson, MS 39216-4500 | 2005-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629675319 | Premier Physical Therapy Consulting | Rehabilitation Unit | 751b Lynwood Ave, Nashville, TN 37203-5029 | 2020-10-06 |
| 1043824279 | Methodist Healthcare East Hospital | Rehabilitation Unit | 5959 Park Ave, Memphis, TN 38119-5200 | 2020-09-04 |
| 1720642523 | Vanderbilt University Medical Center | Rehabilitation Unit | 500 Park Ave, Lebanon, TN 37087-3721 | 2019-04-26 |
| 1598296691 | Memphis Va Medical Center | Rehabilitation Unit | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2017-03-21 |
| 1710368220 | Saint Thomas River Park Hospital, LLC | Rehabilitation Unit | 1559 Sparta St, Mcminnville, TN 37110-1316 | 2015-06-11 |
| 1336520840 | Saint Thomas Stones River Hospital, LLC | Rehabilitation Unit | 324 Doolittle Rd, Woodbury, TN 37190-1139 | 2015-06-11 |
| 1093124521 | Rchp Montana LLC | Rehabilitation Unit | 103 Continental Pl, Suite 200, Brentwood, TN 37027-1041 | 2014-08-08 |
| 1316379738 | Hca Health Services of Tennessee, Inc. | Rehabilitation Unit | 5655 Frist Blvd, Hermitage, TN 37076-2053 | 2013-08-08 |
| 1457640922 | Hca Health Services of Tennessee, Inc. | Rehabilitation Unit | 391 Wallace Rd, Nashville, TN 37211-4851 | 2011-04-05 |
| 1194024588 | La Speech Therapy PC | Rehabilitation Unit | 126 East Main Street, Suite C, Union City, TN 38261-3926 | 2011-03-24 |
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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.