Jackson Clinic PA
Jackson Clinic PA is a healthcare organization registered as Clinical Medical Laboratory in Jackson, TN, holding Type 2 (organization) NPI 1376647545 since 2006. The authorized official on file is Carl Rudd, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1376647545 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jackson Clinic PA |
| Other name | <Unavail> |
| Practice address | 616 W FOREST AVE, Jackson, TN, 38301 |
| Phone | 7314220330 |
| Fax | 7314220220 |
| Enumeration date | 2006-09-11 |
| Last updated in NPPES | 2020-08-22 |
Authorized official
| Name | Carl Rudd |
|---|---|
| Title | Administrator |
| Phone | 7314220330 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | Primary | 0000003266 | TN |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44D0315448 | Other | TN | CLIA |
Copy-ready billing details
Provider: Jackson Clinic PA NPI: 1376647545 Taxonomy: 291U00000X (Clinical Medical Laboratory) Address: 616 W FOREST AVE, Jackson, TN, 38301
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1306831425 | James Appleton | Individual | Urology Physician | Jackson, TN |
| 1376538413 | Elias Bond | Individual | Psychiatry Physician | Jackson, TN |
| 1740258540 | Michael Martindale | Individual | Anesthesiology Physician | Jackson, TN |
| 1649248097 | Maria Datuin | Individual | Physical Therapist | Jackson, TN |
| 1184692303 | Jimmy Crosnoe | Individual | Physical Therapist | Jackson, TN |
| 1548221781 | G. Baker Hubbard Ambulatory Surgery Center | Organization | Ambulatory Surgical Clinic/Center | Jackson, TN |
| 1346284379 | Benny Harper | Individual | Physical Therapist | Jackson, TN |
| 1477668416 | Jackson Clinic Pharmacy Inc | Organization | Clinic Pharmacy | Jackson, TN |
Verify this record
Cross-check NPI 1376647545 against the authoritative CMS record: view Jackson Clinic PA on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Jackson Clinic PA located?
Source: CMS NPPES (public data). Snapshot 2026-07-09. Provider record last updated 2020-08-22.