JACKSON HOSPITAL AND CLINIC INC (NPI# 1407387848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407387848 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC |
| Other Organization Name | JACKSON CLINIC CARDIOTHORACIC SURGERY |
| Practice Address |
1758 Park Pl Suite 202 Montgomery AL 36106-1127 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342647156 |
| Practice Fax Number | 3342647681 |
| Mailing Telephone | 3342938736 |
| Mailing Fax Number | 3342938738 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |
| 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 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Cardiothoracic Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1891156469 | Jackson Hospital and Clinic Inc | Internal Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2016-03-10 |
| 1912362773 | Jackson Hospital and Clinic Inc | Internal Medicine | 1758 Park Pl, Suite 401, Montgomery, AL 36106-1127 | 2015-12-22 |
| 1679946610 | Jackson Hospital and Clinic Inc | Neurological Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2015-11-12 |
| 1740657683 | Jackson Hospital and Clinic Inc | Surgery | 44 Medical Arts Ct, Greenville, AL 36037-3869 | 2015-08-26 |
| 1164803367 | Jackson Hospital and Clinic Inc | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2015-06-12 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1831513787 | Jackson Hospital and Clinic Inc | Surgery | 7201 Copperfield Dr, Montgomery, AL 36117-7101 | 2014-02-13 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| Street Address |
1758 PARK PL SUITE 202 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699765271 | Howard L Brazil | Specialist | 1758 Park Pl, Montgomery, AL 36106-1133 | 2005-10-25 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1912362773 | Jackson Hospital and Clinic Inc | Internal Medicine | 1758 Park Pl, Suite 401, Montgomery, AL 36106-1127 | 2015-12-22 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1528475084 | William Saliski | Nurse Practitioner | 1758 Park Pl, Ste 300, Montgomery, AL 36106-1127 | 2014-07-16 |
| 1093068900 | Stewart H Tankersley, Md, LLC | Clinic/Center | 1758 Park Pl, Suite 200, Montgomery, AL 36106-1127 | 2012-10-17 |
| 1841576915 | Shelley Sanders Byrd | Nurse Practitioner | 1758 Park Pl, Suite 100, Montgomery, AL 36106-1127 | 2011-11-02 |
| 1346566700 | Latoya Shantel Clark | Obstetrics & Gynecology | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2010-04-09 |
| 1013140904 | Southeast Cancer Network, Inc | Internal Medicine | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2009-08-26 |
| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124172242 | Capital Cardiothoracic, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2007-01-23 |
| 1518052356 | Stephen K Kwan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2006-10-04 |
| 1639112964 | Cardiothoracic Surgical Associates of Montgomery, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2055 E South Blvd, Suite 708, Montgomery, AL 36116-2001 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568072189 | Wood Cardiothoracic and Vascular Institute, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Wood Cardiothoracic and Vascular Institute, LLC, 303 Bay Street, Ste. 201, Gadsden, AL 35901-5203 | 2020-08-07 |
| 1811306681 | Shannon Turney | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1515 Toney Dr Se, Huntsville, AL 35802-1249 | 2014-08-06 |
| 1356685416 | Advanced Wound Care and Limb Preservation, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3715 Dauphin St Ste 503b, Mobile, AL 36608-1773 | 2012-11-15 |
| 1851686091 | Trent Howard | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road Ste 100, Vestavia, AL 35243 | 2011-06-16 |
| 1134393507 | Peter Shu Kuen Yu | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 703 Adams St Se, Huntsville, AL 35801-3706 | 2008-04-16 |
| 1487693982 | Carlton Duane Randleman Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2704 20th St S, Ste 100, Birmingham, AL 35209-1924 | 2006-06-06 |
| 1396791604 | Stanley K Lochridge | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-05-26 |
| 1699737155 | John Stephen Thurber | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Rd Ste 100, Vestavia, AL 35243-2560 | 2006-04-03 |
| 1235122177 | Evan Scott Cohen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 201 Sivley Rd Sw, Suite 300, Huntsville, AL 35801-5134 | 2005-08-25 |
| 1639177470 | Peter N/a Pluscht IIi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1855 Springhill Ave, Mobile, AL 36607-2301 | 2005-07-13 |
| 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.