JACKSON HOSPITAL & CLINIC, INC. (NPI# 1730597816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730597816 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL & CLINIC, INC. |
| Other Organization Name | JACKSON HOSPITAL - GERIATRIC PSYCH UNIT |
| Practice Address |
1725 Pine St Montgomery AL 36106-1109 |
| Practice Telephone | 3342938000 |
| Practice Fax Number | 3342938972 |
| Mailing Telephone | 3342938000 |
| Mailing Fax Number | 3342938972 |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | MR. JOE RILEY (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3342938809 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON HOSPITAL & CLINIC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | HOS0024H | 05 |
| Other Name | Type Code |
|---|---|
| Jackson Hospital - Geriatric Psych Unit | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316447063 | Jackson Hospital & Clinic, Inc. | Internal Medicine | 1722 Pine St Ste 406, Montgomery, AL 36106-1159 | 2018-02-20 |
| 1235667544 | Jackson Hospital & Clinic, Inc. | Obstetrics & Gynecology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-05-31 |
| 1720599012 | Jackson Hospital & Clinic, Inc. | Otolaryngology | 1111 Olive St, Montgomery, AL 36106-1129 | 2017-10-13 |
| 1013433820 | Jackson Hospital & Clinic, Inc. | Urology | 80 Herren Hill Rd Ste C, Tallassee, AL 36078-1264 | 2017-08-15 |
| 1245750660 | Jackson Hospital & Clinic, Inc. | Family Medicine | 4150 Carmichael Rd Ste B, Montgomery, AL 36106-2933 | 2017-06-27 |
| 1215464300 | Jackson Hospital & Clinic, Inc. | Surgery | 1801 Pine St Ste 101, Montgomery, AL 36106-1154 | 2017-05-19 |
| Street Address |
1725 PINE ST |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548267339 | Noland Hospital Montgomery II, LLC | Long Term Care Hospital | 1725 Pine St, 6th Floor, North Wing, Montgomery, AL 36106-1109 | 2005-07-07 |
| 1861016909 | Joshua Hunter Pybus | Nurse Anesthetist, Certified Registered | 1725 Pine St, Montgomery, AL 36106-1109 | 2020-06-04 |
| 1063033157 | Kelly Diane Slaten | Pharmacist | 1725 Pine St, Montgomery, AL 36106-1117 | 2020-04-30 |
| 1215572888 | Integrated Care-alabama LLC | Emergency Medicine | 1725 Pine St, Montgomery, AL 36106-1109 | 2019-11-07 |
| 1699336644 | Jasmine Necole Abebe | Registered Nurse | 1725 Pine St, Montgomery, AL 36106-1109 | 2019-06-20 |
| 1619530326 | Ashley Tippins | Nurse Practitioner | 1725 Pine St, Montgomery, AL 36106-3610 | 2019-04-18 |
| 1821550781 | Sharonica Rena Frazier | Registered Nurse | 1725 Pine St, Montgomery, AL 36106-1109 | 2019-04-01 |
| 1497229538 | Michelle L Roll | Nurse Anesthetist, Certified Registered | 1725 Pine St, Montgomery, AL 36106-1109 | 2019-01-11 |
| 1275033441 | Sarah Lauren Monson | Nurse Anesthetist, Certified Registered | 1725 Pine St, Montgomery, AL 36106-1109 | 2018-02-14 |
| 1013424159 | Brenda Simyiu | Pharmacist | 1725 Pine St, Montgomery, AL 36106-1109 | 2018-01-09 |
| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942394739 | The Health Care Authority for Baptist Health, An Affiliate of Uabhs | Psychiatric Unit | 2105 E South Blvd, Montgomery, AL 36116-2409 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528334042 | Tuskegee University | Psychiatric Unit | 115 Basil O'oconnor Hall, Tuskegee, AL 36088-8184 | 2012-03-29 |
| 1043263221 | Affinity Hospital LLC | Psychiatric Unit | 3690 Grandview Pkwy, Birmingham, AL 35243-3326 | 2006-05-18 |
| 1548773450 | The Health Care Authority of The City of Eufaula | Psychiatric Unit | 820 W Washington St, Eufaula, AL 36027-1822 | 2017-11-14 |
| 1548787286 | The Troy Hospital Health Care Authority | Psychiatric Unit | 1330 Highway 231 S, Troy, AL 36081-3058 | 2017-08-24 |
| 1659725901 | Bbh Pbmc, LLC | Psychiatric Unit | 701 Princeton Ave Sw, Birmingham, AL 35211-1303 | 2016-04-22 |
| 1194179440 | Bbh Wbmc, LLC | Psychiatric Unit | 3400 Highway 78 E, Jasper, AL 35501-8956 | 2016-04-22 |
| 1073967329 | Bbh Sbmc,llc | Psychiatric Unit | 1000 1st St N, Alabaster, AL 35007-8703 | 2016-04-22 |
| 1881048221 | Bbh Cbmc, LLC | Psychiatric Unit | 604 Stone Ave, Talladega, AL 35160-2217 | 2016-04-22 |
| 1811341290 | Bbh Bmc, LLC | Psychiatric Unit | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2016-04-21 |
| 1669868923 | Prime Healthcare Services - Gadsden LLC | Psychiatric Unit | 600 S 3rd St, Gadsden, AL 35901-5304 | 2015-04-13 |
| 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.