NPIMap

Organization Active NPI

Jackson Medical Center, LLC

  • Rural Health Clinic/Center
  • Jackson, AL
National Provider Identifier
1891180089
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JACKSON MEDICAL CENTER, LLC
Practice address
220 Hospital Dr
Jackson, AL 36545-2459
Phone
(251) 246-1154
Fax
(251) 246-1108
NPI assigned
Apr 3, 2015
Last updated
Apr 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Amy Gibson
Title
Ceo
Phone
(251) 246-1154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

220 Hospital Dr
Jackson, AL 36545-2459

Mailing address

PO Box 250
Grove Hill, AL 36451-0250
Phone (251) 246-1154

National Provider Directory

National Provider Directory
Tax ID family
Jackson Medical Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1891180089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364510250",
            "telephone_number": "251-246-1154",
            "fax_number": "251-246-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HOSPITAL DR",
            "city": "JACKSON",
            "state": "AL",
            "postal_code": "365452459",
            "telephone_number": "251-246-1154",
            "fax_number": "251-246-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-246-1154"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.