JACKSON HOSPITAL AND CLINIC, INC. (NPI# 1710265905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710265905 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC, INC. |
| Other Organization Name | BASIL O. BURNEY, M.D. |
| Practice Address |
1801 Pine St Suite 203 Montgomery AL 36106-0165 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342938877 |
| Practice Fax Number | 3342936803 |
| Mailing Telephone | 3342709914 |
| Mailing Fax Number | 3342703195 |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2019-06-25 |
| Authorized Official Name | MR. PETER VERRECCHIA (CFO) |
| Authorized Official Telephone | 3342938000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MD.30788 | AL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Basil O. Burney, M.D. | Doing Business As Name - Organization |
| Jackson Clinic Endocrinology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477029072 | Jackson Hospital and Clinic, Inc. | Obstetrics & Gynecology | 1722 Pine St Ste 603, Montgomery, AL 36106-1114 | 2018-10-22 |
| 1497240998 | Jackson Hospital and Clinic, Inc. | Internal Medicine | 1722 Pine St Ste 801, Montgomery, AL 36106-1108 | 2018-06-27 |
| 1477171072 | Jackson Hospital and Clinic, Inc. | Family Medicine | 204 Medical Center Dr, Prattville, AL 36066-7288 | 2020-07-09 |
| 1730727744 | Jackson Hospital and Clinic, Inc. | Specialist | 1840 E Main St, Prattville, AL 36066-5500 | 2019-12-20 |
| 1952949968 | Jackson Hospital and Clinic, Inc. | Pediatrics | 4154 Carmichael Rd, Montgomery, AL 36106-2866 | 2019-12-20 |
| 1205494416 | Jackson Hospital and Clinic, Inc. | Urology | 1722 Pine St Ste 503, Montgomery, AL 36106-1160 | 2019-06-03 |
| 1992296370 | Jackson Hospital and Clinic, Inc. | Surgery | 1722 Pine St Ste 503, Montgomery, AL 36106-1160 | 2018-05-22 |
| 1306229190 | Jackson Hospital and Clinic, Inc. | Hospitalist | 1725 Pine St, Montgomery, AL 36106-1109 | 2015-06-30 |
| 1720325889 | Jackson Hospital and Clinic, Inc. | Family Medicine | 701 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2013-01-09 |
| 1760770754 | Jackson Hospital and Clinic, Inc. | Urology | 1722 Pine St, Suite 502, Montgomery, AL 36106-1103 | 2011-07-12 |
| Street Address |
1801 PINE ST SUITE 203 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-0165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063406338 | Carol L Anders | Nurse Practitioner | 1801 Pine St, Suite 204, Montgomery, AL 36106-0165 | 2005-09-01 |
| 1194178772 | Julie Jenkins | Nurse Practitioner | 1801 Pine St, Suite 203, Montgomery, AL 36106-0165 | 2016-07-19 |
| 1588011746 | Jackson Hospital and Clinic Inc. | Surgery | 1801 Pine St, Suite 101, Montgomery, AL 36106-0165 | 2016-05-18 |
| 1679946610 | Jackson Hospital and Clinic Inc | Neurological Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2015-11-12 |
| 1346619368 | Jodie Shedd | Nurse Practitioner | 1801 Pine St, Suite 302, Montgomery, AL 36106-0165 | 2015-09-21 |
| 1457634818 | Melissa Briana Myer | Physical Therapist | 1801 Pine St, Suite 102, Montgomery, AL 36106-0165 | 2011-09-22 |
| 1831486489 | Tiara Hypolite | Internal Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2011-07-05 |
| 1326270406 | Phillip K Whatley | Physical Therapist | 1801 Pine St, Suite 102, Montgomery, AL 36106-0165 | 2009-08-21 |
| 1720223027 | Jackson Hospital and Clinic, Inc. | Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2008-12-16 |
| 1639314230 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2008-12-10 |
| 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 | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1215355425 | Se Young Suh | Internal Medicine | 1801 Pine St Ste 203, Montgomery, AL 36106-1154 | 2014-04-03 |
| 1689724189 | Endocrinology Associates of Montgomery, Pa | Internal Medicine | 2030 Chestnut St, Montgomery, AL 36106-1111 | 2007-01-10 |
| 1306867288 | Ruth I. Miller-frost | Internal Medicine | 7216 Copperfield Dr, Montgomery, AL 36117-7100 | 2006-07-23 |
| 1477544971 | Robert M Combs Jr. | Internal Medicine | 2165 Normandie Dr, Montgomery, AL 36111-2728 | 2005-11-02 |
| 1184090656 | Warda Niaz | Internal Medicine | 1801 Pine St Ste 203, Montgomery, AL 36106-1154 | 2015-08-19 |
| 1215215389 | Manisha Garg | Internal Medicine | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2454 | 2011-07-23 |
| 1114219409 | Rajasree Nambron | Internal Medicine | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2454 | 2011-05-05 |
| 1700936200 | Bruce S Trippe | Internal Medicine | 2030 Chestnut St, Montgomery, AL 36106-1111 | 2007-01-10 |
| 1881700037 | Veronice Gardner | Internal Medicine | 215 Perry Hill Rd, Vamc Diabetes Clinic, Montgomery, AL 36109-3725 | 2006-08-21 |
| 1124058771 | Mary Monalee Casals | Internal Medicine | 316 Saint Lukes Dr, Montgomery, AL 36117-7102 | 2006-07-03 |
| Find all providers in MONTGOMERY | ||||
| 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.