NPIMap

Organization Active NPI

Jackson Madison County General Hospital

Doing business as West Tennessee Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Jackson, TN
National Provider Identifier
1225029390
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
0000000078 Issued in TN
Legal business name
JACKSON MADISON COUNTY GENERAL HOSPITAL
Doing business as
West Tennessee Rehabilitation Center
Practice address
620 Skyline Drive
Jackson, TN 38301-3901
Phone
(731) 541-6930
Fax
(731) 541-6218
NPI assigned
Oct 28, 2005
Organization subpart
Yes
Parent organization
JACKSON MADISON COUNTY GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Mr. James Ross
Title
Interim President and Ceo
Phone
(731) 541-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 0000000078 TN Primary

Addresses

Primary practice location

620 Skyline Drive
Jackson, TN 38301-3901

Mailing address

620 Skyline Drive
Jackson, TN 38301-3901
Phone (731) 541-6930

Other identifiers 1

IdentifierTypeStateIssuer
044T002MedicaidTN

Other names 1

  • West Tennessee Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
Jere Hammond MD

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1225029390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-541-6930",
            "fax_number": "731-541-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-541-6930",
            "fax_number": "731-541-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MADISON COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON MADISON COUNTY GENERAL HOSPITAL",
        "enumeration_date": "2005-10-28",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "INTERIM PRESIDENT AND CEO",
        "authorized_official_telephone_number": "731-541-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "TN",
            "license": "0000000078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044T002",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Tennessee Rehabilitation Center",
            "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 Apr 29, 2016; 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.