JACKSON HOSPITAL AND CLINIC INC (NPI# 1891156469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891156469 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC |
| Other Organization Name | JACKSON CLINIC CARDIOLOGY |
| Practice Address |
115 Herren Hill Rd Tallassee AL 36078-1276 |
| Mailing Address |
1722 Pine St Suite 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342649191 |
| Practice Fax Number | 3342649199 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2017-03-16 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1407387848 | Jackson Hospital and Clinic Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2017-03-27 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1912362773 | Jackson Hospital and Clinic Inc | Internal Medicine | 1758 Park Pl, Suite 401, Montgomery, AL 36106-1127 | 2015-12-22 |
| 1679946610 | Jackson Hospital and Clinic Inc | Neurological Surgery | 1801 Pine St, Suite 202, Montgomery, AL 36106-0165 | 2015-11-12 |
| 1740657683 | Jackson Hospital and Clinic Inc | Surgery | 44 Medical Arts Ct, Greenville, AL 36037-3869 | 2015-08-26 |
| 1164803367 | Jackson Hospital and Clinic Inc | Urology | 226 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2015-06-12 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1831513787 | Jackson Hospital and Clinic Inc | Surgery | 7201 Copperfield Dr, Montgomery, AL 36117-7101 | 2014-02-13 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| Street Address |
115 HERREN HILL RD |
| City | TALLASSEE |
| State | AL |
| Zip Code | 36078-1276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437122884 | Michael W Peaden | Family Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-02-08 |
| 1659534436 | Barbara Jean Watts | Nurse Practitioner | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2008-07-02 |
| 1023116894 | Irene Alam Bailey | Family Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-09-20 |
| 1407870504 | Marcial J Mendez | Specialist | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-07-26 |
| 1114982360 | Community Hospital, Inc | Internal Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-04-19 |
| 1558326611 | Michael W. Peaden Md PC | Family Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-04-19 |
| 1548233570 | James P Westberry | Internal Medicine | 115 Herren Hill Rd, Tallassee, AL 36078-1276 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811286321 | Kenneth Wesley Atkins | Behavioral Analyst | 101 S Dubois, Tallassee, AL 36078 | 2011-04-05 |
| 1811089030 | Shawn Keahey | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1952409088 | Randal David Herring | Chiropractor | 315 Friendship Road, Tallassee, AL 36078 | 2006-09-20 |
| 1609801133 | Alexander Robbins | Surgery | 875 Friendship Road, Cmac Suite F, Tallassee, AL 36078 | 2006-07-12 |
| 1063467447 | John H Rand | Otolaryngology | 80 Herren Hill Road, Ste D, Tallassee, AL 36078 | 2006-05-23 |
| 1073067856 | Deray Junior Williams | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078 | 2016-08-09 |
| 1881752996 | Charles D Mccartha | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-12-04 |
| 1013009315 | Tallassee Family Dentistry PCc | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1538191648 | Tom Crain | Physical Therapist | 1000 Friendship Rd, Tallassee, AL 36078 | 2006-07-07 |
| 1417412081 | Collin Jones | Specialist/Technologist | 213 Godwin Rd, Tallassee, AL 36078-1129 | 2019-02-07 |
| Find all providers in zip 36078 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1124674098 | Jamie Torres | Internal Medicine | 1118 Ross Clark Cir Ste 403, Dothan, AL 36301-3038 | 2019-08-15 |
| 1770040255 | Druid City Vascular, P.C. | Internal Medicine | 701 University Blvd E Ste 608, Tuscaloosa, AL 35401-7411 | 2019-02-21 |
| 1962933796 | Robert Derenbecker | Internal Medicine | 1808 7th Avenue South Bdb 201, Birmingham, AL 35294-0010 | 2017-03-23 |
| 1770944340 | Jackson Hospital and Clinic, Inc | Internal Medicine | 74238 Tallassee Hwy, Wetumpka, AL 36092-5504 | 2016-03-10 |
| 1750742318 | Jackson Hospital and Clinic Inc | Internal Medicine | 707 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2016-03-10 |
| 1053791764 | Multi-specialty Care-cardiac Care In South, LLC | Internal Medicine | 4490 Al Highway 22, Valley Grande, AL 36701-0501 | 2015-06-08 |
| 1922497312 | Michael Mckinney Cardiology PC | Internal Medicine | 1110 Lakeview Cres, Birmingham, AL 35205-1119 | 2015-01-22 |
| 1194160580 | David Huntsman Jackson | Internal Medicine | 3647 Dunbarton Dr, Mountain Brk, AL 35223-2891 | 2013-04-30 |
| 1700136728 | Farnoosh Rahimi | Internal Medicine | 2451 Fillingim St Bldg C, Mobile, AL 36617 | 2012-09-17 |
| 1720333867 | Rayan Saab | Internal Medicine | 801 Princeton Ave Sw Ste 707, Birmingham, AL 35211-1395 | 2012-07-15 |
| 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.