Jacksonville Hospital LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JACKSONVILLE HOSPITAL LLC

Practice address

501 S Ragsdale St
Jacksonville, TX 75766-2434

Phone

(903) 541-5083

Fax

(903) 541-5068

NPI assigned

Feb 13, 2018

Organization subpart

No

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

Authorized official

Name

Stephen C Petrovich

Title

Evp

Phone

(615) 296-3000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1306346796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BURTON HILLS BLVD STE 250",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156195",
            "telephone_number": "615-296-3000",
            "fax_number": "615-296-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S RAGSDALE ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662434",
            "telephone_number": "903-541-5083",
            "fax_number": "903-541-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.