JACKSON HOSPITAL AND CLINIC INC. (NPI# 1376097089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376097089 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC. |
| Other Organization Name | JACKSON CLINIC INFECTIOUS DISEASE |
| Practice Address |
1722 Pine St Suite 406 Montgomery AL 36106-1103 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342936871 |
| Practice Fax Number | 3342936872 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2016-08-10 |
| 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 | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Infectious Disease | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194256438 | Jackson Hospital and Clinic Inc. | Surgery | 1722 Pine St Ste 201, Montgomery, AL 36106-1158 | 2017-03-27 |
| 1053844654 | Jackson Hospital and Clinic Inc. | Urology | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 | 2017-04-10 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1588011746 | Jackson Hospital and Clinic Inc. | Surgery | 1801 Pine St, Suite 101, Montgomery, AL 36106-0165 | 2016-05-18 |
| 1164878856 | Jackson Hospital and Clinic Inc. | Internal Medicine | 461 E Main St, Prattville, AL 36067-3409 | 2016-05-11 |
| 1811350390 | Jackson Hospital and Clinic Inc. | Internal Medicine | 124 S Memorial Dr, Prattville, AL 36067-3619 | 2016-04-01 |
| 1528449386 | Jackson Hospital and Clinic Inc. | Durable Medical Equipment & Medical Supplies | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2015-06-17 |
| 1023317666 | Jackson Hospital and Clinic Inc. | Family Medicine | 1801 Pine Street, Suite 103, Montgomery, AL 36106-1160 | 2011-03-22 |
| Street Address |
1722 PINE ST SUITE 406 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316949472 | Aubrey Ayers Stabler Jr. | Otolaryngology | 1722 Pine St, Suite 804, Montgomery, AL 36106-1108 | 2005-06-02 |
| 1609435155 | Virginia Mcdaniel | Nurse Practitioner | 1722 Pine St, Montgomery, AL 36106-1103 | 2019-06-09 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1619352895 | Tammie Holcey | Nurse Practitioner | 1722 Pine St, Suite 1005, Montgomery, AL 36106-1103 | 2015-07-29 |
| 1528449386 | Jackson Hospital and Clinic Inc. | Durable Medical Equipment & Medical Supplies | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2015-06-17 |
| 1285030080 | Greater Montgomery Patient Centered Gastroenterology and Hepatology | Internal Medicine | 1722 Pine St, Suite 801, Montgomery, AL 36106-1103 | 2014-11-06 |
| 1396152823 | S Louis Armstrong Md PC | Surgery | 1722 Pine St, Suite 201, Montgomery, AL 36106-1103 | 2014-07-16 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| 1033467196 | Jacquelin Ratunil Chua | Internal Medicine | 1722 Pine St, Montgomery, AL 36106 | 2012-08-21 |
| 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 | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1770969404 | Mladen Sokanovic | Internal Medicine | 1725 Pine St, Montgomery, AL 36106-1109 | 2015-08-04 |
| 1255481230 | Infectious Disease Specialists of Mtg PC | Internal Medicine | 1801 Pine St, Montgomery, AL 36106-0165 | 2007-01-11 |
| 1538229414 | William David Hewitt | Internal Medicine | 2257 Taylor Rd, Suite 200, Montgomery, AL 36117-7790 | 2006-12-11 |
| 1184738478 | The University of Alabama At Birmingham | Internal Medicine | 2055 E South Blvd, Suite 202, Montgomery, AL 36116-2002 | 2006-08-17 |
| 1346200516 | Wickliffe J Many Jr. | Internal Medicine | 2055 E South Blvd, Suite 202, Montgomery, AL 36116 | 2006-03-23 |
| 1699755975 | Glenn David Bedsole | Internal Medicine | 1801 Pine St, Montgomery, AL 36106-0165 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831584556 | Lily Colpitts | Internal Medicine | 4704 Cahaba River Rd Ste D, Birmingham, AL 35243-2344 | 2015-03-31 |
| 1750707824 | Scott D Parker Md LLC | Internal Medicine | 250 Chateau Dr Sw Ste 115, Huntsville, AL 35801-3497 | 2014-03-12 |
| 1306109103 | Birmingham Infectious Diseases, PC | Internal Medicine | 4704 Cahaba River Rd Ste 101d, Birmingham, AL 35243-2344 | 2012-06-18 |
| 1699032649 | Jo Hofmann | Internal Medicine | Division of Infectious Diseases, Uab, 1900 University Blvd Tht 215, Birmingham, AL 35233 | 2012-04-16 |
| 1780982546 | Richard A Kaslow | Internal Medicine | 1665 University Blvd, Ryals 220, Birmingham, AL 35294 | 2011-03-03 |
| 1841506870 | Jean Hilaire Vincent | Internal Medicine | 541 W College St Ste 2400, Florence, AL 35630-5320 | 2010-08-27 |
| 1134452279 | Andres Felipe Gutierrez Ordonez | Internal Medicine | 1102 Monroe St Sw, Huntsville, AL 35801-5029 | 2009-09-08 |
| 1003090986 | Jodie Ann Dionne-odom | Internal Medicine | 908 20th Street South 1917 Clinic, Birmingham, AL 35294 | 2007-12-27 |
| 1841494515 | Karen Fagin Md LLC | Internal Medicine | 2000 Pepperell Pkwy Bldg 190, Opelika, AL 36801-5452 | 2007-06-14 |
| 1578624508 | Greer Anne Burkholder | Internal Medicine | 908 South 20th Street, Ccb 2nd Floor, Birmingham, AL 35294-2050 | 2006-12-13 |
| Find all providers with the same taxonomy | ||||
| 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.