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JACKSON HOSPITAL & CLINIC, INC.
NPI 1013433820
Urology in Tallassee, AL

Active since August 15, 2017CLIA Certified · 6 labs
80 HERREN HILL RD STE C, TALLASSEE, AL 36078(334) 293-8588(334) 293-6978 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 9, 2026, Jun 16, 2018, Aug 15, 2017 (3 updates tracked since 2017).

About Jackson Hospital & Clinic, Inc. NPPES

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

JACKSON HOSPITAL & CLINIC, INC. (NPI 1013433820), doing business as Jackson Clinic Urology Tallassee, is a healthcare organization registered as an urology in Tallassee, Alabama and active in the NPI registry since August 2017. The organization holds 6 active CLIA laboratory certificates and lists Kelin Penney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1013433820
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameJACKSON HOSPITAL & CLINIC, INC.
Location Address80 HERREN HILL RD STE CTallassee, AL 36078-1264
Mailing Address1722 Pine St Ste 804Montgomery, AL 36106-1108 · (334) 293-8736 · Fax (334) 293-8738
Phone(334) 293-8588
Fax(334) 293-6978
Organization SubpartNo
Authorized OfficialKelin PenneyExecutive Director · (334) 240-2335
Enumeration DateAugust 15, 2017
Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1013433820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
80 HERREN HILL RD STE C, Tallassee, AL 36078
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Other Names 1

Doing Business AsJackson Clinic Urology Tallassee

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

CLIA Laboratory Certificates CMS CLIA 7

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 01D2179342

Jackson Hospital & Clinic, Inc · Prattville, AL
Active · expires Feb 19, 2028
CLIA Number01D2179342
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorJade Hoy
Laboratory Phone(334) 240-2335
Laboratory LocationJackson Hospital & Clinic, Inc1840 E Main Street, Prattville, AL 36066
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D2179343

Jackson Hospital & Clinic, Inc · Greenville, AL
Active · expires Feb 19, 2028
CLIA Number01D2179343
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorChristopher Waguespack
Laboratory Phone(334) 240-2335
Laboratory LocationJackson Hospital & Clinic, Inc321 Greenville Bypass, Suite 4, Greenville, AL 36037
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D0721873

Jackson Hospital & Clinic, Inc · Montgomery, AL
Active · expires Mar 31, 2028
CLIA Number01D0721873
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorDr. Alfred Newman
Laboratory Phone(334) 265-6933
Laboratory LocationJackson Hospital & Clinic, Inc1722 Pine Street Suite 903, Montgomery, AL 36106
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 01D2174024

Jackson Hospital & Clinic Inc · Montgomery, AL
Active · expires Oct 22, 2027
CLIA Number01D2174024
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorAggarwal Himanshu
Laboratory Phone(334) 293-8273
Laboratory LocationJackson Hospital & Clinic Inc1722 Pine Street Suite 503, Montgomery, AL 36106
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 01D0304164

Jackson Hospital & Clinic · Montgomery, AL
Active · expires Feb 27, 2027
CLIA Number01D0304164
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorLemuel D. Gorden
Laboratory Phone(334) 293-8794
Laboratory LocationJackson Hospital & Clinic1725 Pine Street, Montgomery, AL 36106
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 01D2033164

Jackson Hospital And Clinic · Montgomery, AL
Active · expires Nov 22, 2027
CLIA Number01D2033164
Laboratory TypePhysician Office
Certificate Effective DateNovember 23, 2025
Certificate Expiration DateNovember 22, 2027
Laboratory DirectorDr. Peter Shashy
Laboratory Phone(334) 293-8588
Laboratory LocationJackson Hospital And Clinic1722 Pine Street Suite 502, Montgomery, AL 36106
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

JACKSON HOSPITAL & CLINIC, INC.
Obstetrics & Gynecology
80 HERREN HILL RD STE C
TALLASSEE, AL 36078
Elmore County (334) 284-1500
KAYTON WELDON
Peer Specialist
80 HERREN HILL RD STE C
TALLASSEE, AL 36078
Elmore County (334) 640-0300
RURAL ADDICTION PREVENTION
Voluntary or Charitable
80 HERREN HILL RD STE C
TALLASSEE, AL 36078
Elmore County (205) 882-7007

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 Hospital & Clinic, Inc.'s NPI number?

The NPI number for Jackson Hospital & Clinic, Inc. is 1013433820. It was assigned to this organization in the NPPES registry on August 15, 2017. The provider is doing business as Jackson Clinic Urology Tallassee.

Where is Jackson Hospital & Clinic, Inc. located?

Jackson Hospital & Clinic, Inc. is located at 80 Herren Hill Rd Ste C, Tallassee, AL 36078. The listed phone number is (334) 293-8588.

What is Jackson Hospital & Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Jackson Hospital & Clinic, Inc. hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Jackson Hospital & Clinic, Inc. was last updated on March 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.