JACKSON MADISON COUNTY GENERAL HOSPITAL (NPI# 1255547980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255547980 |
| Entity Type | Organization |
| Organization Name | JACKSON MADISON COUNTY GENERAL HOSPITAL |
| Other Organization Name | SKILLED NURSING INFECTIOUS DISEASE RAD |
| Practice Address |
708 W Forest Ave Jackson TN 38301-3901 |
| Mailing Address |
1804 Highway 45 Byp Suite 604 Jackson TN 38305-4436 |
| Practice Telephone | 7316608759 |
| Practice Fax Number | 7316608739 |
| Mailing Telephone | 7316608759 |
| Mailing Fax Number | 7316608739 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-05-16 |
| Authorized Official Name | JAMA M PHILLIPS (DIRECTOR PHYSICIAN BILLING) |
| Authorized Official Telephone | 7315121510 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON MADISON COUNTY GENERAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Skilled Nursing Infectious Disease Rad | 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 |
| 1225029390 | Jackson Madison County General Hospital | Rehabilitation Unit | 620 Skyline Drive, Jackson, TN 38301-3901 | 2005-10-28 |
| 1205265485 | Jackson Madison County General Hospital | Durable Medical Equipment & Medical Supplies | 720 W Forest Ave, Jackson, TN 38301-3904 | 2013-11-07 |
| 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 |
708 W FOREST AVE |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417958216 | Robert E Turner IIi | Emergency Medicine | 708 W Forest Ave, Jackson, TN 38301-3901 | 2005-08-03 |
| 1295981496 | Amber Lynn Stafford | Nurse Anesthetist, Certified Registered | 708 W Forest Ave, Jackson, TN 38301-3901 | 2008-08-07 |
| 1508020744 | Susan D Crocker | Nurse Anesthetist, Certified Registered | 708 W Forest Ave, Jackson, TN 38301 | 2008-07-16 |
| 1679736516 | Jackson Pathology Group A Professional Corporation | Pathology | 708 W Forest Ave, Jackson, TN 38301-3901 | 2008-07-09 |
| 1699954636 | Victor Go | Hospitalist | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-10-26 |
| 1811184484 | Amy Renee' Anderson | Occupational Therapist | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-09-27 |
| 1609082338 | Jackson Madison County General Hospital | Internal Medicine | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-05-16 |
| 1700090461 | Brian James Shaw | Pharmacist | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-05-10 |
| 1336271303 | Katherine Carr Greer | Physical Therapist | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-03-12 |
| 1811039704 | Jackson-madison County General Hospital | Pharmacy | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-02-14 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063890754 | Phil Otis Nelson Jr. | Radiology | 146 Ridge Dr, Jackson, MS 39216-4109 | 2015-05-13 |
| 1891030946 | Cherry Hill Radiology Pllc | Radiology | 401 Redfield Dr, Jackson, TN 38305-8555 | 2012-11-30 |
| 1245414275 | Breathit County Imaging Center | Radiology | 1389 Ky Hwy 15 North, St. John Newmans Medical Plaza, Jackson, KY 41339 | 2007-12-27 |
| 1407933930 | Karen Collette Jensen | Radiology | 14 Adams Road, Jackson, NH 03846 | 2006-11-01 |
| 1770676801 | Gerald O Daniel | Radiology | 708 W Forest Avenue, Jackson, TN 38301 | 2006-10-02 |
| 1497761837 | Arlin George Hatfield IIi | Radiology | 1405 North State Street, Suite 200, Jackson, MS 39202 | 2006-07-31 |
| 1225083942 | Robert Houston Hardin Jr. | Radiology | 2210 Heritage Hill Dr, Jackson, MS 39211-5821 | 2006-05-23 |
| 1881655967 | Jane Warne Brown | Radiology | 91 Stonehaven Cir, Jackson, TN 38305-1945 | 2006-03-29 |
| 1780645028 | Andrew Laurence Rivard | Radiology | 2500 State Street, University of Mississippi Medical Center, Jackson, MS 39216 | 2006-03-28 |
| 1013985134 | John A. Sullivan | Radiology | 7330 Ryegrass Road, Jackson, WY 83001 | 2006-03-14 |
| 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.