NPIMap

Organization Active NPI

Jackson Physician Corp

Doing business as Jackson Orthopedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Jackson, KY
National Provider Identifier
1063712701
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
JACKSON PHYSICIAN CORP
Doing business as
Jackson Orthopedic Clinic
Practice address
540 Jett Dr
Jackson, KY 41339-9622
Phone
(606) 666-6300
Fax
(606) 666-6118
NPI assigned
Oct 28, 2010
Last updated
Dec 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Debbie Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X TN Primary

Addresses

Primary practice location

540 Jett Dr
Jackson, KY 41339-9622

Mailing address

540 Jett Dr
Jackson, KY 41339-9622
Phone (606) 666-6300

Other names 1

  • Jackson Orthopedic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

21992 Main St
Hyden, KY 41749
Phone (606) 672-5200

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1063712701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JETT DR",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399622",
            "telephone_number": "606-666-6300",
            "fax_number": "606-666-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JETT DR",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399622",
            "telephone_number": "606-666-6300",
            "fax_number": "606-666-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PHYSICIAN CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Orthopedic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.