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
1730132499 MRS. KATHERINE SPRATLEY LEWIS, CNM
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1104971209 HOLLY MICHELLE WILLIAMS, CNM, MSN
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1285042366 HANNAH WILKINSON DUNLAP, CNM
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1467487488 SHERIDAN L SKARL, 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 Field Definition 1
1 NPI 1396770442 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name JACKSON MADISON COUNTY GENERAL HOSPITAL The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name WEST TENNESSEE OBGYN Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 110 E FOREST AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name JACKSON The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name TN The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 383014124 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 7316608759 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 7316608739 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 7/11/2006 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 1/25/2008 The date that a record was last updated or changed.
16 Authorized Official Last Name PHILLIPS The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name JAMA The first name of the authorized official.
18 Authorized Official Middle Name M The middle name of the authorized official.
19 Authorized Official Title or Position DIRECTOR PHYSICIANS BILLING The title or position of the authorized official.
20 Authorized Official Telephone Number 7315121510 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 367A00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
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 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
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: 2/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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