Alan F Jacks, MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

96-01640 Issued in NC

Legal business name

ALAN F JACKS, MD PA

Practice address

845 Malcolm Blvd
Rutherford College, NC 28671-0476

Phone

(828) 874-0555

Fax

(828) 874-2111

NPI assigned

Jul 20, 2005

Last updated

Sep 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alan F. Jacks, M.D.

Title

President

Phone

(828) 874-0555

Specialties & licenses 1

Addresses

Other identifiers 4

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.

• Shana C Rhyne, ANP

  • Adult Health Nurse Practitioner
  • Connelly Springs, NC
  • NPI 1407109309
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1669471777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 476",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "286710476",
            "telephone_number": "828-874-0555",
            "fax_number": "828-874-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 MALCOLM BLVD",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "286710476",
            "telephone_number": "828-874-0555",
            "fax_number": "828-874-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN F JACKS, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "JACKS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-874-0555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "96-01640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909135",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1013E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891013E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "96-01640",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Allen Arensman, MD
• Beacon Inhome Care, Inc.
• Better Living Home Care
• Blue Ridge Healthcare Hospitals, Inc. (CMC Blue Ridge)
• Blue Ridge Healthcare Hospitals, Inc. (CMC Blue Ridge)

• Surgery Physician in Rutherford College, NC
• Providers in Rutherford College, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.