JACKSON HOSPITAL AND CLINIC, INC (NPI# 1861827297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861827297 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC, INC |
| Other Organization Name | JACKSON FAMILY MEDICINE PIKE ROAD |
| Practice Address |
11123 Chantilly Pkwy Ct Ste M Pike Road AL 36064-2880 |
| Mailing Address |
1722 Pine St Ste 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342938888 |
| Mailing Telephone | 3342938888 |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | KELIN PENNEY (ADMINISTRATOR) |
| Authorized Official Telephone | 3342402335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Family Medicine Pike Road | Doing Business As Name - Organization |
| Jackson Hospital and Clinic Inc Pike Road | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528699444 | Jackson Hospital and Clinic, Inc | Specialist | 321 Greenville Byp Ste 2, Greenville, AL 36037-3757 | 2020-01-29 |
| 1770944340 | Jackson Hospital and Clinic, Inc | Internal Medicine | 74238 Tallassee Hwy, Wetumpka, AL 36092-5504 | 2016-03-10 |
| 1306447958 | Jackson Hospital and Clinic, Inc | Colon & Rectal Surgery | 1722 Pine St Ste 402, Montgomery, AL 36106-1159 | 2020-11-02 |
| 1497362172 | Jackson Hospital and Clinic, Inc | Family Medicine | 4035 Atlanta Hwy, Montgomery, AL 36109-2920 | 2020-09-28 |
| 1659879633 | Jackson Hospital and Clinic, Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2018-01-25 |
| 1639314230 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2008-12-10 |
| 1114082393 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1801 Pine St, Suite 302, Montgomery, AL 36106-1154 | 2006-12-27 |
| 1093870339 | Jackson Hospital and Clinic, Inc | Family Medicine | 1801 Pine St, Suite 301, Montgomery, AL 36106-0165 | 2006-12-27 |
| 1104981380 | Jackson Hospital and Clinic, Inc | Family Medicine | 1801 Pine St, Suite 204, Montgomery, AL 36106-0165 | 2006-12-27 |
| 1376568964 | Jackson Hospital and Clinic, Inc | Internal Medicine | 1725 Pine St, Montgomery, AL 36106-1109 | 2006-07-13 |
| Street Address |
11123 CHANTILLY PKWY CT STE M |
| City | PIKE ROAD |
| State | AL |
| Zip Code | 36064-2880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841475480 | Jennifer Morgan Billingsley Richardson | Dentist | 11123 Chantilly Pkwy Ct, Suite I, Pike Road, AL 36064-2880 | 2008-01-02 |
| 1376833947 | Designer Smiles Dental Studio, P.C. | Clinic/Center | 11123 Chantilly Pkwy Ct, Suite I, Pike Road, AL 36064-2880 | 2011-04-15 |
| 1275775165 | Christopher Joseph Waguespack | Family Medicine | 11123 Chantilly Pkwy Ct, Suite M, Pike Road, AL 36064-2880 | 2009-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770068 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 9515 Vaughn Road, Pike Road, AL 36064 | 2020-11-03 |
| 1053806331 | Pike Road Dental, LLC | Clinic/Center | 31 Bridge St, Pike Road, AL 36064 | 2018-06-28 |
| 1437605292 | Woods Pt LLC | Physical Therapist | 9907 Turtle River Road, Pike Road, AL 36064 | 2016-08-31 |
| 1174854509 | Joseph Maurice Scanlan | Ophthalmology | 175 Pike Road Trail, Pike Road, AL 36064 | 2010-01-25 |
| 1821284514 | Colleen Irving Hawthorne | Speech-Language Pathologist | 345 Dansby Ct., Pike Road, AL 36064 | 2007-09-17 |
| 1285842617 | Rachel Lee Stewart | Physical Therapist | 9708 Silver Bell Ct, Pike Road, AL 36064 | 2007-05-18 |
| 1851565907 | Jeanell Jones Norvell | Counselor | 1196 Meriwether Rd, Pike Road, AL 36064-1721 | 2008-04-19 |
| 1295777126 | Theodore M Morgan Sr. | Emergency Medicine | 155 Glynlakes Dr, Pike Road, AL 36064-1767 | 2006-06-12 |
| 1710420351 | Melinda Landrum | Counselor | 9427 Vaughn Rd, Suite 27, Pike Road, AL 36064-2210 | 2016-11-30 |
| 1881160281 | Memendra Page Harris | Counselor | 9427 Vaughn Rd Ste F, Pike Road, AL 36064-2255 | 2018-10-23 |
| Find all providers in zip 36064 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275775165 | Christopher Joseph Waguespack | Family Medicine | 11123 Chantilly Pkwy Ct, Suite M, Pike Road, AL 36064-2880 | 2009-03-24 |
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|---|---|---|---|---|
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| 1497354617 | Southcoast Medical Services | Family Medicine | 34463 Us Highway 98 Ste G, Lillian, AL 36549-4049 | 2020-10-19 |
| 1154929131 | Jackson Tuley Cornelison | Family Medicine | 41 Eminence Way Ste A, Pell City, AL 35128-2338 | 2020-10-13 |
| 1740895200 | Escambia County Alabama Community Hospitals, Inc | Family Medicine | 609 E. Laurel Street, Atmore, AL 36502 | 2020-09-11 |
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| 1053920264 | Mms Life, LLC | Family Medicine | 401 Evergreen Ave, Brewton, AL 36426-2066 | 2020-07-24 |
| 1164040986 | Marshall Primary Care | Family Medicine | 7938 Al Highway 69 Ste 350, Guntersville, AL 35976-7135 | 2020-07-08 |
| 1750907507 | Agape Medicine, LLC | Family Medicine | 42598 State Highway 75, Snead, AL 35952-6566 | 2020-06-17 |
| 1750906921 | Doctors Making Home Visits 1st Inc | Family Medicine | 922 S Perry St, Montgomery, AL 36104-5022 | 2020-06-12 |
| 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.