Jackson Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JACKSON FAMILY PRACTICE LLC

Practice address

500 Burlington Rd
Suite 260
Jackson, OH 45640-9360

Phone

(740) 577-9181

Fax

(740) 577-9214

NPI assigned

Jan 28, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Maryann Hartwick

Title

Practice Manager

Phone

(740) 577-9181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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.

• Russell Albert Hartwick Jr., DO

  • Family Medicine Physician
  • Jackson, OH
  • NPI 1235116583
  Medicare reassignment NPD

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1467819920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456400190",
            "telephone_number": "740-577-9181",
            "fax_number": "740-577-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BURLINGTON RD",
            "address_2": "SUITE 260",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409360",
            "telephone_number": "740-577-9181",
            "fax_number": "740-577-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-03-24",
        "status": "A",
        "authorized_official_last_name": "HARTWICK",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "740-577-9181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Payton Jade, Entler Israel
• Jackson Chiropractic Clinic, Inc.
• Jackson City School District
• Jackson County Board on Aging, Inc.
• Jackson Dialysis and Kidney Center
• Jackson Foot and Ankle Clinic
• Jackson Health Partners LLC (Holzer Assisted Living Jackson)
• Jackson Healthcare LLC
• Jackson Urgent Care
• Charlotte Ann Jackson

• Family Medicine Physician in Jackson, OH
• Providers in Jackson, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.