Active NPI
Jackson Tennessee Hospital Company LLC
- General Acute Care Hospital
- Jackson, TN
National Provider Identifier
1023089984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 0000000079
- Legal business name
- JACKSON TENNESSEE HOSPITAL COMPANY LLC
- Practice address
- 367 Hospital Blvd
Jackson, TN 38305-2080 - Phone
- (731) 661-2000
- NPI assigned
- Jan 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula M Lalor
- Title
- Director/Delegated Official
- Phone
- (615) 925-4565
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 0000000079 | TN | Primary |
Addresses
Primary practice location
367 Hospital Blvd
Jackson, TN 38305-2080
Mailing address
367 Hospital Blvd
Jackson, TN 38305-2080
Phone (731) 661-2000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 440008 | Medicaid | TN | |
| 136770 | Medicaid | TN | |
| 0440189 | Medicaid | TN | |
| 25834 | Medicaid | TN | |
| 4048506 | Other | BCBS |
Other names 1
- Tennova Healthcare-Regional Jackson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 440189
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- TENNOVA HEALTHCARE-REGIONAL JACKSON
- Certification status
- Terminated Voluntary: merger or closure, Jun 1, 2018
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Aug 31, 1980
- Last certification
- Oct 21, 1998
- Beds
- 150
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- Jan 1, 2003 (3 total)
- Facility address
- 367 Hospital Blvd
Jackson, TN 38305
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1520899200000",
"number": "1023089984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 HOSPITAL BLVD",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052080",
"telephone_number": "731-661-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "367 HOSPITAL BLVD",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052080",
"telephone_number": "731-661-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON TENNESSEE HOSPITAL COMPANY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-30",
"last_updated": "2018-03-13",
"status": "A",
"authorized_official_last_name": "LALOR",
"authorized_official_first_name": "PAULA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
"authorized_official_telephone_number": "615-925-4565"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "TN",
"license": "0000000079",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "440008",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136770",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0440189",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "25834",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4048506",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Tennova Healthcare-Regional Jackson",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jackson, TN
- Jackson Regional Womens Center
- Jackson Residential, LLC
- Jackson Senior Services, LLC
- Jackson Spa LLC
- Jackson Surgical Associates. PA
- Jackson Transit Authority
- Jackson Urological Associates, P.C.
- Jackson Weight Management, Inc.
- Jackson-Madison County Gen Hospital
- Jackson-Madison County General Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.