NPIMap

Organization Active NPI

Jackson Medical Center, L.L.C.

  • General Acute Care Hospital
  • Jackson, AL
National Provider Identifier
1043430226
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H1032 Issued in AL
Legal business name
JACKSON MEDICAL CENTER, L.L.C.
Practice address
220 Hospital Dr
Jackson, AL 36545-2459
Phone
(251) 246-9021
Fax
(251) 246-1122
NPI assigned
Apr 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Ryland
Title
Assistant Administrator
Phone
(251) 246-9021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1032 AL Primary

Addresses

Primary practice location

220 Hospital Dr
Jackson, AL 36545-2459

Mailing address

220 Hospital Dr
Jackson, AL 36545-2459
Phone (251) 246-9021

Other identifiers 2

IdentifierTypeStateIssuer
010115OtherALBLUE CROSS BLUE SHIELD
HOS0128HMedicaidAL

Other names 1

  • Emergency Room Other name

National Provider Directory

National Provider Directory
Tax ID family
Jackson Medical Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043430226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HOSPITAL DR",
            "city": "JACKSON",
            "state": "AL",
            "postal_code": "365452459",
            "telephone_number": "251-246-9021",
            "fax_number": "251-246-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HOSPITAL DR",
            "city": "JACKSON",
            "state": "AL",
            "postal_code": "365452459",
            "telephone_number": "251-246-9021",
            "fax_number": "251-246-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYLAND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "251-246-9021"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "H1032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010115",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0128H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Room",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.