NPIMap

Organization Active NPI

QHG of Jacksonville Inc

Doing business as Jacksonville Medical Center

  • Anesthesiology Physician
  • Jacksonville, AL
National Provider Identifier
1457458820
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
QHG OF JACKSONVILLE INC
Doing business as
Jacksonville Medical Center
Practice address
1701 Pelham Rd S
Jacksonville, AL 36265-3353
Phone
(256) 435-4970
NPI assigned
Sep 20, 2006
Last updated
Feb 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
QHG OF JACKSONVILLE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(877) 892-9813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary
Emergency Medicine Physician 207P00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1701 Pelham Rd S
Jacksonville, AL 36265-3353

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829

Other names 1

  • Jacksonville Medical Center Doing business as

National Provider Directory

National Provider Directory
Part of
Family Care Health Cent

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1457458820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PELHAM RD S",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653353",
            "telephone_number": "256-435-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QHG OF JACKSONVILLE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QHG OF JACKSONVILLE INC",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 8, 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.