NPIMap

Organization Active NPI

Methodist Healthcare-Memphis Hospitals

Doing business as Le Bonheur Children's Hospital-Jackson

  • General Acute Care Hospital
  • Jackson, TN
National Provider Identifier
1053067512
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
METHODIST HEALTHCARE-MEMPHIS HOSPITALS
Doing business as
Le Bonheur Children's Hospital-Jackson
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(901) 487-1057
NPI assigned
Feb 23, 2022
Last updated
Feb 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Michael Wiggins
Title
Ceo
Phone
(901) 287-5952

Specialties & licenses 1

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

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

1211 Union Ave Ste 700
Memphis, TN 38104-6600
Phone (901) 478-1057

Other names 1

  • Le Bonheur Children's Hospital-Jackson Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address methodist.lebonheur.jackson@direct.mlh.org

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2257759Lebonheur Children's Hospital-Jackson620 Skyline Drive, B3, Jackson, TN 38301Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Methodist Healthcare-12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1053067512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 700",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046600",
            "telephone_number": "901-478-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "901-487-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTHCARE-MEMPHIS HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-287-5952"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "methodist.lebonheur.jackson@direct.mlh.org",
            "affiliation": "N",
            "endpointDescription": "exchanging health information",
            "address_1": "620 Skyline Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383013923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Le Bonheur Children's Hospital-Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.