NPIMap

Organization Active NPI

Jackson Madison County General Hospital

Doing business as JMCGH Radiology Professional

  • Diagnostic Radiology Physician
  • Jackson, TN
National Provider Identifier
1891687208
Registry record updated Oct 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
JACKSON MADISON COUNTY GENERAL HOSPITAL
Doing business as
JMCGH Radiology Professional
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-5000
Fax
(731) 660-8739
NPI assigned
Jul 18, 2025
Last updated
Oct 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2026

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

Authorized official

Name
Bartley Teague
Title
Executive Director
Phone
(731) 512-1277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 660-8759

Other names 1

  • JMCGH Radiology Professional Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ Other Management Services Network, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO, TN, MI, GA, UT, AL7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20251014001427 FL Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 1 practitioner
Practice locations: Bonita Springs, FL
O20251014003126 CO Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO
O20251017000051 TN Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 22 practitioners
Practice locations: Jackson, TN; Lexington, TN; Martin, TN; Milan, TN; Selmer, TN; South Fulton, TN; Henderson, TN; Halls, TN…
O20251029002750 MI Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 2 practitioners
Practice locations: Caledonia, MI; Grand Rapids, MI
O20251111000047 GA Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 1 practitioner
Practice locations: Chickamauga, GA
O20260120000466 UT Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, UT
O20260529001139 AL Part B Supplier - Clinic/Group Practice 3678481975 Receives reassigned benefits from 1 practitioner
Practice locations: Hoover, AL

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
East Jackson Family Me11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations (25 of 35)

300 Climer Loop N
Alamo, TN 38001
Phone (731) 696-3095

7264 Cedar Grove Rd
Big Sandy, TN 38221
Phone (731) 593-0389

163 E Main St
Bradford, TN 38316
Phone (731) 742-2241

216 E Main St
Bradford, TN 38316
Phone (731) 742-2241

187 Hospital Dr
Camden, TN 38320
Phone (731) 584-0396

1012 Forrest St
Dyersburg, TN 38024
Phone (731) 285-2222

274 S Church Ave
Henderson, TN 38340
Phone (731) 989-2127

320 Quinco Dr
Henderson, TN 38340
Phone (731) 989-2127

1040 Greystone Sq
Jackson, TN 38305
Phone (731) 410-2367

1061 W Forest Ave
Jackson, TN 38301
Phone (731) 660-6954

1068 Vann Dr
Jackson, TN 38305
Phone (731) 668-4524

1270 Union University Dr
Ste A
Jackson, TN 38305
Phone (731) 664-0103

1725 S Highland Ave
Ste D
Jackson, TN 38301
Phone (731) 421-8116

300 Coatsland Dr
Jackson, TN 38301
Phone (731) 541-8850

33 Directors Row
Jackson, TN 38305
Phone (731) 313-7688

3550 N Highland Ave
Jackson, TN 38305
Phone (731) 660-2324

44 Forest Cv
Jackson, TN 38301
Phone (731) 265-0854

512 Roland Ave
Jackson, TN 38301
Phone (731) 421-6950

534 Roland Ave
Jackson, TN 38301
Phone (731) 422-1100

57 Quinn Dr
Jackson, TN 38301
Phone (731) 424-9957

60 Auditorium St
Jackson, TN 38301
Phone (731) 424-1600

614 Carriage House Dr
Jackson, TN 38305
Phone (731) 668-4449

657 Skyline Dr
Ste B
Jackson, TN 38301
Phone (731) 541-5385

668 Lexington Ave
Jackson, TN 38301
Phone (431) 423-8542

700 W Forest Ave
Jackson, TN 38301
Phone (731) 424-8922

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Tennessee Healthcare Milan HospitalMilan, TN, CCN 440060 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 27, 1998
West Tennessee Healthcare Milan HospitalMilan, TN, CCN 44U060 Hospital 5% Or Greater Direct Ownership Interest (5%) Aug 24, 1998
Jackson Madison County General HospitalJackson, TN, CCN 440002 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2007
West Tennessee Healthcare Rehabilitation Hospital Jackson, a PartnershJackson, TN, CCN 443036 Hospital 5% Or Greater Direct Ownership Interest (50%) Oct 8, 2015
West Tennessee Healthcare Rehabilitation Hospital Cane Creek, a PartneMartin, TN, CCN 443030 Hospital 5% Or Greater Direct Ownership Interest (50%) Jul 1, 2017
West Tennessee Healthcare Rehabilitation Hospital Cane Creek, a PartneMartin, TN, CCN 44Y030 Hospital 5% Or Greater Direct Ownership Interest (50%) Jul 1, 2017
West Tennessee Healthcare Volunteer HospitalMartin, TN, CCN 440061 Hospital Operational/Managerial Control Jan 2, 2019
West Tennessee Healthcare Dyersburg HospitalDyersburg, TN, CCN 440072 Hospital 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control (50%)		 Jun 1, 2018
Jun 1, 2018
Select Specialty Hospital - West TennesseeJackson, TN, CCN 442018 Hospital 5% Or Greater Direct Ownership Interest (15%) Mar 1, 2023
Extendicare Home Health of Western TennesseeUnion City, TN, CCN 447434 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Oct 1, 2008
Extendicare Home Health of West TennesseeDyersburg, TN, CCN 447284 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Sep 1, 2007
Medical Center Home Health, LLCJackson, TN, CCN 447101 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Oct 1, 2008
Hospice of West TennesseeJackson, TN, CCN 441514 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1986
West Tennessee Medical Group Primary Care CaruthersvilleCaruthersville, MO, CCN 793800 Rural health clinic Operational/Managerial Control Jun 1, 2018

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Practitioners & affiliated clinicians

Practitioners 116

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 116

NPI Registry JSON

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792195200000",
    "number": "1891687208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BANCORP SOUTH PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057582",
            "telephone_number": "731-660-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MADISON COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "BARTLEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-512-1277"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.1036.1",
            "affiliationName": "Management Services Network, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2357 Warm Springs Rd Ste 400",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319046874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JMCGH Radiology Professional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.