Jackson OB/GYN

Primary specialty

SpecialistTaxonomy code 174400000X

License

MM012522 Issued in MI

Legal business name

JACKSON OB/GYN

Practice address

300 W Washington Ave
Ste 60
Jackson, MI 49201-2180

Phone

(517) 787-0334

Fax

(517) 787-2114

NPI assigned

Apr 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael McDonnell, D.O.NPI 1164412961

Title

Owner

Phone

(517) 787-0334

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Michael S McDonnell, D.O.

  • Obstetrics & Gynecology Physician
  • Jackson, MI
  • NPI 1164412961
  Authorized official Same address or phone

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083679971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 60",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-787-0334",
            "fax_number": "517-787-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "STE 60",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-787-0334",
            "fax_number": "517-787-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-787-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "MM012522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Health Network L3C
• Jackson Heart PLLC
• Jackson Home Medical Equipment, Inc. (The Aumack Company)
• Jackson Implants & Periodontics
• Jackson OB-GYN PLC
• Jackson Opco, LLC (Regency at Jackson)
• Jackson Orthopaedic Care & Surgery, P.C.
• Jackson Orthopaedic Care & Surgery, P.C.
• Jackson Orthopedic Specialist
• Jackson Orthopedics Specialist

• Specialist in Jackson, MI
• Providers in Jackson, MI by specialty
• Specialist in Michigan

• 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.