NPIMap

Organization Active NPI

Jackson Medical Services

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1396063012
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
JACKSON MEDICAL SERVICES
Practice address
9 Physicians Dr
Jackson, TN 38305-2071
Phone
(731) 661-0086
Fax
(731) 660-9055
NPI assigned
May 5, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Bob SouderNPI 1316934664
Title
Owner
Phone
(731) 664-0266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

9 Physicians Dr
Jackson, TN 38305-2071

Mailing address

81 Stonebridge Blvd
Jackson, TN 38305-2042
Phone (731) 664-8300

National Provider Directory

National Provider Directory

Locations

81 Stonebridge Blvd
Jackson, TN 38305

9 Physicians Dr
Jackson, TN 38305
Phone (731) 661-0086

Practitioners & affiliated clinicians

Practitioners 3

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": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1396063012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052042",
            "telephone_number": "731-664-8300",
            "fax_number": "731-664-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052071",
            "telephone_number": "731-661-0086",
            "fax_number": "731-660-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "SOUDER",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-664-0266"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 31, 2010; 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.