JACKSON MADISON COUNTY GENERAL HOSPITAL (NPI# 1689608853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689608853 |
| Entity Type | Organization |
| Organization Name | JACKSON MADISON COUNTY GENERAL HOSPITAL |
| Other Organization Name | AFFILIATE ER |
| Practice Address |
650 Nuckolls Rd Bolivar TN 38008-1532 |
| 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 | 2006-07-11 |
| 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 | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals | ||
| N | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Affiliate ER | 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 |
| 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 |
| Street Address |
650 NUCKOLLS RD |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-1532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518957950 | Bolivar General Hospital, Inc. | Medicare Defined Swing Bed Unit | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2005-10-26 |
| 1659713386 | Top Flight Medical Group | Specialist | 650 Nuckolls Rd, Specialty Clinic, Bolivar, TN 38008-1532 | 2013-07-23 |
| 1003181819 | Nathan Strickland | Dietitian, Registered | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2012-03-12 |
| 1205979002 | Bolivar General Hospital Pharmacy | Pharmacy | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-02-14 |
| 1174545446 | Bolivar General Hospital, Inc. | General Acute Care Hospital | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-24 |
| 1760412654 | George Spanos | Emergency Medicine | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-04 |
| 1770521940 | William Raymond Carney | Emergency Medicine | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-06-02 |
| 1689665754 | Bolivar General Hospital, Inc. | Medicare Defined Swing Bed Unit | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003981549 | Citizens Memorial Hospital District | General Acute Care Hospital | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174033906 | Behavioral Health of Rocky Top, LLC | General Acute Care Hospital | 210 Industrial Park Dr, Rocky Top, TN 37769-2301 | 2017-10-06 |
| 1104290667 | Michelle Mcconnell Spradley | General Acute Care Hospital | 5006 Dell Dr, Mount Juliet, TN 37122-4157 | 2015-11-20 |
| 1215301981 | Cheryl Hall Wideman | General Acute Care Hospital | 3721 Russell Hurst Dr E, Bartlett, TN 38135-1965 | 2015-11-18 |
| 1104206135 | Vanderbilt University | General Acute Care Hospital | 62 Parks Ln, Fayetteville, TN 37334-6642 | 2015-06-04 |
| 1306247515 | Fort Sanders Regional Medical Center | General Acute Care Hospital | 614 Emory Oak Ct, Knoxville, TN 37909-3439 | 2014-09-07 |
| 1740609130 | Select Specialty | General Acute Care Hospital | 2000 Hayes St Ste 1502, Nashville, TN 37203-2318 | 2014-04-14 |
| 1710301320 | Veronica Blackman | General Acute Care Hospital | 447 Shelley Renee Ln, Cordova, TN 38018-4310 | 2014-02-18 |
| 1962826107 | Hoke Steven Fitzgerald | General Acute Care Hospital | 1073 Smithfield Rd, Tellico Plains, TN 37385-6137 | 2014-02-07 |
| 1336560598 | Vanderbilt University Medical Center | General Acute Care Hospital | 607 Medical Arts Building, 1121 21st Avenue South, Nashville, TN 37232-1320 | 2013-12-13 |
| 1710314554 | Centennial | General Acute Care Hospital | 552 Metroplex Dr, Nashville, TN 37211-3133 | 2013-10-10 |
| Find all providers with the same taxonomy | ||||
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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.