Jackson Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in AL

Legal business name

JACKSON SURGERY CENTER, LLC

Practice address

1725 Park PL
Montgomery, AL 36106-1138

Phone

(334) 293-8484

Fax

(334) 293-6880

NPI assigned

Jun 9, 2009

Organization subpart

No

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

Authorized official

Name

Missy Sallas

Title

Administrator

Phone

(334) 293-3920

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Listed as

Jackson Surgery Center LLCCCN 01C0001053

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Jackson Hospital and Clinic, Inc

  • Colon & Rectal Surgery Physician
  • Montgomery, AL
  • NPI 1306447958

  Member Of

  NPD member

Practitioners 1

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

• Gilbert N Clinton II, MD

  • Anesthesiology Physician
  • Benton, AR
  • NPI 1154383289
  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1336375930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 PARK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061138",
            "telephone_number": "334-293-8484",
            "fax_number": "334-293-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PARK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061138",
            "telephone_number": "334-293-8484",
            "fax_number": "334-293-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "SALLAS",
        "authorized_official_first_name": "MISSY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-293-3920"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Hospital and Clinic, Inc.
• Jackson Hospital and Clinic, Inc.
• Jackson Hospital and Clinics
• Jackson Montgomery Emergency Physcians, LLC
• Jackson Montgomery Hospitalists, LLC
• Jacqueline Jackson-James
• Allison Jackson
• Anna Jackson, BCBA
• Candice Grace Jackson, NP-C
• Ciana Alexandria Jackson

• Ambulatory Surgical Clinic/Center in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Ambulatory Surgical Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.