The Medical Clinic of Jackson

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE MEDICAL CLINIC OF JACKSON

Practice address

587 Skyline Dr
Jackson, TN 38301-3911

Phone

(731) 424-8922

Fax

(731) 423-2922

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Amy Ridley

Title

Office Manager

Phone

(731) 424-8922

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert H Dunnebacke, M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1629295738
  NPD
• Kevin G Gray, M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1952528077
  NPD
• Conrado B Sioson Jr., M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1235356361
  NPD

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043437130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL CLINIC OF JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-424-8922"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Tharpe, RN0000144089
• The Cardiovascular Clinic of West Tennessee,P.C.
• The Children'S Clinic of West Tennessee P.a.
• The David Vickery Limited Partnership
• The Grove Behavorial Health Services, Inc
• The Pratt Clinic, PLLC
• The Starting Place, LLC
• The Steets Corporation
• The Urban Eye PC
• The West Clinic, PLLC

• Internal Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Internal Medicine Physician in Tennessee

• 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.