JACKSON HOSPITAL CORPORATION (NPI# 1679774996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679774996 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL CORPORATION |
| Other Organization Name | KENTUCKY RIVER ER, ANESTH, RADIOLOGY |
| Practice Address |
540 Jett Dr Jackson KY 41339-9622 |
| Practice Telephone | 6066666000 |
| Practice Fax Number | 6066666107 |
| Mailing Telephone | 6066666000 |
| Mailing Fax Number | 6066666107 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | DEBBIE T BREWER (DIRECTOR) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON HOSPITAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 74900580 | 05 | |
| KY | 65938276 | 05 |
| Other Name | Type Code |
|---|---|
| Kentucky River ER, Anesth, Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083950414 | Jackson Hospital Corporation | Clinic/Center | 1027 Highway 11 N, Beattyville, KY 41311-9240 | 2012-12-12 |
| 1912518978 | Jackson Hospital Corporation | Clinic/Center | 424 Jett Dr, Jackson, KY 41339-9621 | 2020-08-13 |
| 1992044747 | Jackson Hospital Corporation | Internal Medicine | 1027 Highway 11 N, Beattyville, KY 41311-9240 | 2013-02-13 |
| 1417293846 | Jackson Hospital Corporation | Clinic/Center | 49 Ky 15 N, Campton, KY 41301-7284 | 2012-12-12 |
| 1750626339 | Jackson Hospital Corporation | Internal Medicine | 49 Ky 15 N, Campton, KY 41301-7284 | 2012-12-07 |
| 1295985596 | Jackson Hospital Corporation | Medicare Defined Swing Bed Unit | 540 Jett Dr, Jackson, KY 41339-9622 | 2008-09-23 |
| 1346247962 | Jackson Hospital Corporation | General Acute Care Hospital | 540 Jett Dr, Jackson, KY 41339-9622 | 2005-06-29 |
| Street Address |
540 JETT DR |
| City | JACKSON |
| State | KY |
| Zip Code | 41339-9622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124928 | Louis P Ellen | Optometrist | 540 Jett Dr, Jackson, KY 41339-9622 | 2005-06-17 |
| 1144841412 | Sound Physicians Anesthesiology of Kentucky Psc | Anesthesiology | 540 Jett Dr, Jackson, KY 41339-9622 | 2020-04-28 |
| 1841825767 | Breathitt Emergency Group, LLC | Physician Assistant | 540 Jett Dr, Jackson, KY 41339-9622 | 2020-03-11 |
| 1053960534 | Brittney Denise Herald | Nurse Practitioner | 540 Jett Dr, Jackson, KY 41339-9622 | 2019-09-08 |
| 1851842199 | Carl Gross | Physician Assistant | 540 Jett Dr, Jackson, KY 41339-9622 | 2016-10-21 |
| 1174970909 | Whitaker National Corporation | Physician Assistant | 540 Jett Dr, Jackson, KY 41339 | 2016-05-23 |
| 1174913172 | Advanced Surgical Specialists of Ky, Pllc | Surgery | 540 Jett Dr, Jackson, KY 41339-9622 | 2015-01-28 |
| 1063712701 | Jackson Physician Corp | Durable Medical Equipment & Medical Supplies | 540 Jett Dr, Jackson, KY 41339-9622 | 2010-10-28 |
| 1174752356 | Kentucky River Hbp LLC | Radiology | 540 Jett Dr, Jackson, KY 41339-9622 | 2009-07-08 |
| 1295985596 | Jackson Hospital Corporation | Medicare Defined Swing Bed Unit | 540 Jett Dr, Jackson, KY 41339-9622 | 2008-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
| 1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
| 1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
| 1023641446 | Andreanna Gibbs | Physical Therapy Assistant | 100 Hwy 15, Jackson, KY 41339 | 2020-02-13 |
| 1144797754 | Visionary Rehabilitation Services, LLC | Speech-Language Pathologist | 100 Kentucky Hwy 15 South, Suite 136, Jackson, KY 41339 | 2018-11-01 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| 1508225996 | Jessica Williams | Pharmacist | 842 Highway 15 N, Jackson, KY 41339 | 2016-02-15 |
| 1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
| 1265784045 | Jonathan Charles Morris | Physical Therapist | 695 Ky Hwy 15 N, Ste 3, Jackson, KY 41339 | 2012-10-04 |
| 1649539958 | Henry Price Sewell IIi IIi | Family Medicine | 170 Picnic Hill Rd, Jackson, KY 41339 | 2012-05-07 |
| Find all providers in zip 41339 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891141032 | Tobin S Dennis | Emergency Medicine | 625 East Broadway Ave, Jackson, WY 83001-8642 | 2016-05-06 |
| 1902270093 | Steven Pirtle French | Emergency Medicine | 6605 N Snake River Woods Dr, Jackson, WY 83001-8491 | 2015-11-30 |
| 1942612015 | Emergency Associates Pllc | Emergency Medicine | 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 | 2014-05-23 |
| 1083995674 | Obhg Mississippi, P.C. | Emergency Medicine | 1225 N State St Ste B1, Jackson, MS 39202-2072 | 2011-09-09 |
| 1508180183 | Jon Edward Zamber | Emergency Medicine | 361 Willie Adams Rd, Jackson, TN 38305-7223 | 2010-03-25 |
| 1750510962 | Jason Robert Schwanebeck | Emergency Medicine | University of Missisippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505 | 2009-07-09 |
| 1366629214 | Joseph Scott Savage | Emergency Medicine | 400 N Alpine Lake Dr, Suite F, Jackson, MI 49203-6334 | 2008-01-23 |
| 1689709610 | Dawn Nicole Laws | Emergency Medicine | 1325 N West Ave, Jackson, MI 49202-2050 | 2007-02-22 |
| 1194834747 | Joseph W Blackston | Emergency Medicine | 1900 Petit Bois St N, Jackson, MS 39211-6707 | 2006-08-29 |
| 1174637318 | Kaushal Patel | Emergency Medicine | 205 Trace Dr, Jackson, TN 38305-1580 | 2006-08-17 |
| 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.