NPIMap

Organization Active NPI

Jacksonville Surgical & Medical Affiliates, LLC

  • Clinic/Center
  • Jacksonville, AL
National Provider Identifier
1104078831
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JACKSONVILLE SURGICAL & MEDICAL AFFILIATES, LLC
Practice address
1460 2ND Ave SW
Jacksonville, AL 36265-3358
Phone
(256) 782-4395
NPI assigned
Oct 13, 2008
Last updated
Oct 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Authorized official

Name
Tammy Cobb, CPA
Title
Cfo
Phone
(256) 782-4520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1460 2ND Ave SW
Jacksonville, AL 36265-3358

Mailing address

1460 2ND Ave SW
Jacksonville, AL 36265-3358
Phone (256) 782-4395

National Provider Directory

National Provider Directory

Locations

111 Big Valley Dr
Alexandria, AL 36250
Phone (256) 241-3097

80 Spring Branch Rd
Ste F
Alexandria, AL 36250
Phone (256) 820-5244

1219 Almon St
#D
Heflin, AL 36264
Phone (256) 463-3234

1460 2nd Ave SW
Jacksonville, AL 36265
Phone (256) 435-2180

1460A 2nd Ave SW
Jacksonville, AL 36265
Phone (256) 435-2180

1465 1st Ave SW
Ste D
Jacksonville, AL 36265
Phone (256) 782-4299

Practitioners & affiliated clinicians

Practitioners 7

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": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1104078831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 2ND AVE SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653358",
            "telephone_number": "256-782-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 2ND AVE SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653358",
            "telephone_number": "256-782-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE SURGICAL & MEDICAL AFFILIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-782-4520",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.