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JACKSON CLINIC UROLOGY WETUMPKA
NPI 1053844654
Urology in Wetumpka, AL

Active since April 10, 2017
515 HOSPITAL DR, SUITE A, WETUMPKA, AL 36092(334) 293-8588(334) 293-6978 Get Directions Write a Review

NPPES record last updated: April 10, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jackson Clinic Urology Wetumpka NPPES

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

JACKSON CLINIC UROLOGY WETUMPKA (NPI 1053844654) is a healthcare organization registered as an urology in Wetumpka, Alabama and active in the NPI registry since April 2017. The organization lists Tara Herring, Revenue Cycle Director, as its authorized official.

NPPES Registry Identity

NPI1053844654
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameJACKSON HOSPITAL AND CLINIC INC.
Location Address515 HOSPITAL DR, SUITE AWetumpka, AL 36092-1626
Mailing Address1722 Pine St, Suite 503Montgomery, AL 36106-1103 · (334) 293-8736 · Fax (334) 293-8738
Phone(334) 293-8588
Fax(334) 293-6978
Organization SubpartNo
Authorized OfficialTara HerringRevenue Cycle Director · (334) 240-2337
Enumeration DateApril 10, 2017
✔ NPI 1053844654 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.
515 HOSPITAL DR, Wetumpka, AL 36092
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Other Names 1

Doing Business AsJackson Clinic Urology Wetumpka

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Clinic Urology Wetumpka is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

247

Medicare enrollment records show 247 clinicians reassign Medicare billing to Jackson Clinic Urology Wetumpka, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 26

Nurse Practitioner86
Internal Medicine39
Family Practice26
Cardiovascular Disease (Cardiology)10
General Surgery9
Hospitalist8
Otolaryngology8
Urology7
18 other specialties54

Nearest to this location (20)

See all 247
Megan Brown, CRNP
Nurse Practitioner
NPI 1407360845
515 HOSPITAL DR STE A
Wetumpka, AL 36092
(334) 279-9333
✔ PECOS✔ Accepts MedicareSame address
Marlene Wilson-Lavalley, NP-C
Nurse Practitioner
NPI 1275919698
500 HOSPITAL DR
Wetumpka, AL 36092
(334) 514-3713
✔ PECOS✔ Accepts Medicare0.2 mi
Tommy Garnett, DPM
Podiatry
NPI 1992865794
74186 TALLASSEE HIGHWAY STE A
Wetumpka, AL 36092
(334) 514-6922
✔ PECOS✔ Accepts Medicare0.5 mi
Ronaldo Dejesus, MD
Hospitalist
NPI 1962552448
41 CAMBRIDGE COURT
Wetumpka, AL 36093
(334) 567-5626
✔ PECOS✔ Accepts Medicare4.0 mi
Amanda Bailey, CRNP
Nurse Practitioner
NPI 1255864732
26 PECAN CIR
Millbrook, AL 36054
(334) 235-1753
✔ PECOS✔ Accepts Medicare11 mi
Steven Allen, MD
Family Practice
NPI 1508814922
3769 HWY 14
Millbrook, AL 36054
(334) 285-3222
✔ PECOS✔ Accepts Medicare11 mi
Mohammad Ahmed, M.D.
Cardiovascular Disease (Cardiology)
NPI 1457358053
185 MITYLENE PARK LN
Montgomery, AL 36117
(334) 387-0948
✔ PECOS12 mi
Oluyinka Adediji, MD
Emergency Medicine
NPI 1245226612
215 WINTON M BLOUNT LOOP
Montgomery, AL 36117
(334) 239-9480
✔ PECOS✔ Accepts Medicare12 mi
Richard Crum, M.D.
Interventional Cardiology
NPI 1164456570
273 WINTON M BLOUNT LOOP
Montgomery, AL 36117
(334) 280-1500
✔ PECOS✔ Accepts Medicare12 mi
Stephen Chandler, M.D.
Otolaryngology
NPI 1386752723
350 TAYLOR RD STE 2200
Montgomery, AL 36117
(334) 747-7500
✔ PECOS✔ Accepts Medicare12 mi
Sandra Whaley, DPT
Physical Therapist in Private Practice
NPI 1285679746
454 TAYLOR RD
Montgomery, AL 36117
(334) 613-9000
✔ Accepts Medicare12 mi
Brian Gary, M.D.
General Surgery
NPI 1720181886
470 TAYLOR RD STE 202
Montgomery, AL 36117
(334) 244-6773
✔ PECOS✔ Accepts Medicare12 mi
Joshua Waits, M.D.
Urology
NPI 1730323056
470 TAYLOR RD STE 201
Montgomery, AL 36117
(334) 747-9720
✔ PECOS✔ Accepts Medicare12 mi
Brian Sellers, D.O.
Vascular Surgery
NPI 1801916788
7085 SYDNEY CURV
Montgomery, AL 36117
(334) 246-4774
✔ PECOS✔ Accepts Medicare12 mi
Mukeshkumar Patel, MD
Internal Medicine
NPI 1861459703
4212 CARMICHAEL CT N
Montgomery, AL 36106
(334) 213-8804
✔ PECOS✔ Accepts Medicare14 mi
Latoya Clark, MD
Obstetrics/Gynecology
NPI 1346566700
1758 PARK PL SUITE 406
Montgomery, AL 36106
(251) 716-4744
✔ PECOS✔ Accepts Medicare14 mi
Elaina Adderley, MD
Endocrinology
NPI 1699220988
1801 PINE STREET, SUITE 204 THE JACKSON CLINIC
Montgomery, AL 36106
(334) 293-8877
✔ PECOS✔ Accepts Medicare14 mi
Richard Salazar Montero, MD
Neurology
NPI 1245436955
1801 PINE ST SUITE 202
Montgomery, AL 36106
(334) 293-8082
✔ PECOS✔ Accepts Medicare14 mi
Vijaya Boyella, MD
Gastroenterology
NPI 1932263993
1722 PINE ST STE 204
Montgomery, AL 36106
(334) 293-6825
✔ PECOS✔ Accepts Medicare14 mi
Jacquelin Chua, MD
Rheumatology
NPI 1033467196
1722 PINE ST
Montgomery, AL 36106
(334) 293-8000
✔ PECOS✔ Accepts Medicare14 mi
See all 247 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 And Clinic Inc.'s NPI number?

The NPI number for Jackson Hospital And Clinic Inc. is 1053844654. It was assigned to this organization in the NPPES registry on April 10, 2017. The provider is doing business as Jackson Clinic Urology Wetumpka.

Where is Jackson Hospital And Clinic Inc. located?

Jackson Hospital And Clinic Inc. is located at 515 Hospital Dr Suite A, Wetumpka, AL 36092. The listed phone number is (334) 293-8588.

What is Jackson Hospital And Clinic Inc.'s specialty?

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

Is Jackson Hospital And Clinic Inc. enrolled in Medicare?

Yes. Jackson Hospital And Clinic Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Hospital And Clinic Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 247 clinicians in 26 Medicare specialties reassign their Medicare billing to Jackson Hospital And Clinic Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (86), Internal Medicine (39) and Family Practice (26). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jackson Hospital And Clinic Inc. was last updated on April 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.