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JACKSON MEDICAL CENTER PC
NPI 1508048125
Family Medicine in Jackson, MO

Active since December 05, 2007
2387 W JACKSON BLVD, JACKSON, MO 63755(573) 243-9288(573) 204-7074 Get Directions Write a Review

NPPES record last updated: October 7, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 7, 2020, Oct 10, 2016 (2 updates tracked since 2016).

About Jackson Medical Center Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON MEDICAL CENTER PC (NPI 1508048125) is a healthcare organization registered as a family medicine in Jackson, Missouri and active in the NPI registry since December 2007. The organization lists Stacey L Cantrell, Manager, as its authorized official.

NPPES Registry Identity

NPI1508048125
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJACKSON MEDICAL CENTER PC
Location Address2387 W JACKSON BLVDJackson, MO 63755-3024
Mailing Address2387 W Jackson BlvdJackson, MO 63755-3024 · (573) 243-9288 · Fax (573) 204-7074
Phone(573) 243-9288
Fax(573) 204-7074
Organization SubpartNo
Authorized OfficialStacey L CantrellManager · (573) 335-1779
Enumeration DateDecember 5, 2007
Last NPPES UpdateOctober 7, 20202 updates tracked since enumeration
NPPES CertifiedOctober 7, 2020
✔ NPI 1508048125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2387 W JACKSON BLVD, Jackson, MO 63755
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEOFFREY LEE ENDERS DPT
Physical Therapist
2387 W JACKSON BLVD, SUITE C
JACKSON, MO 63755
Cape Girardeau County (573) 243-0210
JUSTIN FRANKE
Physical Therapist
2387 W JACKSON BLVD
JACKSON, MO 63755
Cape Girardeau County (573) 243-0210
DR. JULIA ANNETTE PEWITT D.O.
Family Medicine
2387 W JACKSON BLVD
JACKSON, MO 63755
Cape Girardeau County (573) 243-9288
CHARLES S PEWITT DO
Family Medicine
2387 W JACKSON BLVD
JACKSON, MO 63755
Cape Girardeau County (573) 243-9288
DR. JERRELL LEE DRIVER PHD
Psychologist (Clinical)
2387 W JACKSON BLVD, SUITE B
JACKSON, MO 63755
Cape Girardeau County (573) 204-7771

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Medical Center PC's NPI number?

The NPI number for Jackson Medical Center PC is 1508048125. It was assigned to this organization in the NPPES registry on December 5, 2007.

Where is Jackson Medical Center PC located?

Jackson Medical Center PC is located at 2387 W Jackson Blvd, Jackson, MO 63755. The listed phone number is (573) 243-9288.

What is Jackson Medical Center PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jackson Medical Center PC was last updated on October 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.