NPIMap

Organization Active NPI

Jackson Hospital Corporation

Doing business as Kentucky River ER, Anesth, Radiology

  • Emergency Medicine Physician
  • Jackson, KY
National Provider Identifier
1679774996
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
JACKSON HOSPITAL CORPORATION
Doing business as
Kentucky River ER, Anesth, Radiology
Practice address
540 Jett Dr
Jackson, KY 41339-9622
Phone
(606) 666-6000
Fax
(606) 666-6107
NPI assigned
May 31, 2007
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Debbie T Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X
Emergency Medicine Physician 207P00000X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

540 Jett Dr
Jackson, KY 41339-9622

Mailing address

540 Jett Dr
Jackson, KY 41339-9622
Phone (606) 666-6000

Other identifiers 2

IdentifierTypeStateIssuer
74900580MedicaidKY
65938276MedicaidKY

Other names 1

  • Kentucky River ER, Anesth, Radiology Doing business as

National Provider Directory

National Provider Directory
Part of
Community Medical Clini

Practitioners & affiliated clinicians

Practitioners 86

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 86

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1679774996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JETT DR",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399622",
            "telephone_number": "606-666-6000",
            "fax_number": "606-666-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JETT DR",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399622",
            "telephone_number": "606-666-6000",
            "fax_number": "606-666-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON HOSPITAL CORPORATION",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74900580",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65938276",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky River ER, Anesth, Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.