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JACKSONVILLE HOSPITAL LLC
NPI 1770082299
Clinic/Center - Rural Health in Rusk, TX

Active since February 10, 2018
1325 N DICKINSON DR, RUSK, TX 75785(903) 583-3600(903) 583-3595 Get Directions Write a Review

NPPES record last updated: October 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacksonville Hospital Llc NPPES

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

JACKSONVILLE HOSPITAL LLC (NPI 1770082299) is a healthcare organization registered as a rural health in Rusk, Texas and active in the NPI registry since February 2018. The organization lists Stephen C Petrovich, Evp, as its authorized official.

NPPES Registry Identity

NPI1770082299
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameJACKSONVILLE HOSPITAL LLC
Location Address1325 N DICKINSON DRRusk, TX 75785-1051
Mailing Address340 Seven Springs Way Ste 100Brentwood, TN 37027-5697 · (615) 296-3000 · Fax (615) 296-6227
Phone(903) 583-3600
Fax(903) 583-3595
Organization SubpartYesParent: Ahs East Texas Health System, Llc
Authorized OfficialStephen C PetrovichEvp · (615) 296-3000
Enumeration DateFebruary 10, 2018
Last NPPES UpdateOctober 1, 2023
NPPES CertifiedOctober 1, 2023
✔ NPI 1770082299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1325 N DICKINSON DR, Rusk, TX 75785
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2010097

Jacksonville Hospital, LLC · Rusk, TX
Expired · Jul 19, 2026
CLIA Number45D2010097
Laboratory TypeRural Health Clinic
Certificate Effective DateJuly 20, 2024
Certificate Expiration DateJuly 19, 2026
Laboratory DirectorTodd S. Hendrickson
Laboratory Phone(903) 541-5396
Laboratory LocationJacksonville Hospital, LLC1325 North Dickinson, Rusk, TX 75785
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.

BONNER EMERGENCY MEDICINE ASSOCIATES PA
Emergency Medicine
1325 N DICKINSON DR
RUSK, TX 75785
Cherokee County (903) 683-3601
EAST TEXAS MEDICAL CENTER JACKSONVILLE
Clinic/Center (Rural Health)
1325 N DICKINSON DR
RUSK, TX 75785
Cherokee County (903) 683-3600
MISTY FERGUSSON
Nurse Practitioner (Family)
1325 N DICKINSON DR
RUSK, TX 75785
Cherokee County (903) 683-3600
LISA KATHRYN TRAWICK NP
Nurse Practitioner (Family)
1325 N DICKINSON DR
RUSK, TX 75785
Cherokee County (903) 683-5555
SHANA L BROWN CNP
Nurse Practitioner
1325 N DICKINSON DR
RUSK, TX 75785
Cherokee County (903) 683-3600

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 Jacksonville Hospital LLC's NPI number?

The NPI number for Jacksonville Hospital LLC is 1770082299. It was assigned to this organization in the NPPES registry on February 10, 2018.

Where is Jacksonville Hospital LLC located?

Jacksonville Hospital LLC is located at 1325 N Dickinson Dr, Rusk, TX 75785. The listed phone number is (903) 583-3600.

What is Jacksonville Hospital LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Jacksonville Hospital LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Jacksonville Hospital LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacksonville Hospital LLC was last updated on October 1, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.