JACKSON MADISON COUNTY GENERAL HOSPITAL (WEST TENNESSEE OBGYN) - NPI NUMBER 1396770442

Summary

Provider Name: JACKSON MADISON COUNTY GENERAL HOSPITAL (WEST TENNESSEE OBGYN)

NPI Number: 1396770442

Clasification: Advanced Practice Midwife (367A00000X)

Address:
110 E FOREST AVE
JACKSON, TN
ZIP 38301

Phone Number: (731) 660-8759



Detailed Information

JACKSON MADISON COUNTY GENERAL HOSPITAL is an advanced practice midwife in Jackson, TN. The provider is midwifery practice as conducted by certified nurse-midwives (CNMs) and certified midwives (CMs) is the independent management of women's health care, focusing particularly on pregnancy, childbirth, the post partum period, care of the newborn, and the family planning and gynecologic needs of women. The CNM and CM practice within a health care system that provides for consultation, collaborative management, or referral, as indicated by the health status of the client. CNMs and CMs practice in accord with the Standards for the Practice of Midwifery, as defined by the American College of Nurse-Midwives (ACNM). The assigned NPI number for this provider is 1396770442 and is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As West Tennessee Obgyn.

The provider's business address is:

110 E FOREST AVE
JACKSON, TN
ZIP 38301-124
Phone: (731) 660-8759
Fax: (731) 660-8739

The provider's authorized official is Jama M Phillips .
The authorized official title is Director Physicians Billing and has the following contact phone number (731) 512-1510.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 1/25/2008.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1003831785 JACKSON MADISON COUNTY GENERAL HOSPITAL
Advanced Practice Midwife
1104971209 HOLLY MICHELLE WILLIAMS, CNM, MSN
Advanced Practice Midwife
1285042366 HANNAH WILKINSON DUNLAP, CNM
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1467487488 SHERIDAN L SKARL, CNM
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1730132499 MRS. KATHERINE SPRATLEY LEWIS, CNM
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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 367A00000X Advanced Practice Midwife No
2 207V00000X Obstetrics & Gynecology Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 3273714 MEDICARE PIN TN

NPI Record

No. Field Name Field Value
1 NPI 1396770442
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name JACKSON MADISON COUNTY GENERAL HOSPITAL
5 Provider Other Organization Name WEST TENNESSEE OBGYN
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 110 E FOREST AVE
8 Provider Business Practice Location Address City Name JACKSON
9 Provider Business Practice Location Address State Name TN
10 Provider Business Practice Location Address Postal Code 383014124
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 7316608759
13 Provider Business Practice Location Address Fax Number 7316608739
14 Provider Enumeration Date 7/11/2006
15 Last Update Date 1/25/2008
16 Authorized Official Last Name PHILLIPS
17 Authorized Official First Name JAMA
18 Authorized Official Middle Name M
19 Authorized Official Title or Position DIRECTOR PHYSICIANS BILLING
20 Authorized Official Telephone Number 7315121510
21 Healthcare Provider Taxonomy Code 1 367A00000X
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 207V00000X
24 Healthcare Provider Primary Taxonomy Switch 2 Y
25 Other Provider Identifier 1 3273714
26 Other Provider Identifier Type Code 1 08
27 Other Provider Identifier State 1 TN
28 Is Organization Subpart Y
29 Parent Organization LBN JACKSON MADISON COUNTY GENERAL HOSPITAL
30 Parent Organization TIN
31 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
32 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 8/12/2014
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