JACKSON HOSPITAL AND CLINIC, INC.
NPI 1205494416
Urology - Urogynecology and Reconstructive Pelvic Surgery in Montgomery, AL
About Jackson Hospital And Clinic, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON HOSPITAL AND CLINIC, INC. (NPI 1205494416), doing business as Jackson Clinic Urogynecology, is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Montgomery, Alabama and active in the NPI registry since June 2019. The organization maintains 2 additional practice locations and lists Kelin Penney, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Secondary Practice Locations 2
Group Practice 1
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 Hospital And Clinic, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
247Medicare enrollment records show 247 clinicians reassign Medicare billing to Jackson Hospital And Clinic, Inc., which bills Medicare for the services they deliver. Of these, 57 practice at this address and 167 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 26
Nearest to this location (20)
See all 247Source: 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 1205494416. It was assigned to this organization in the NPPES registry on June 3, 2019. The provider is doing business as Jackson Clinic Urogynecology and Jackson Clinic Urogynecology - Clanton.
Where is Jackson Hospital And Clinic, Inc. located?
Jackson Hospital And Clinic, Inc. is located at 1722 Pine St Ste 503, Montgomery, AL 36106. The listed phone number is (334) 293-8736.
What is Jackson Hospital And Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Urology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 2088F0040X.
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, 57 practice at this address and 167 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 March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.
# Jackson Hospital And Clinic, Inc. · NPI 1205494416
Urogynecology and Reconstructive Pelvic Surgery organization in Montgomery, Alabama. Organization record, active in the CMS NPPES registry since June 3, 2019.
## Identity
- **NPI:** 1205494416 (Entity type: Organization)
- **Enumerated:** June 3, 2019
- **Primary specialty:** Urology - Urogynecology and Reconstructive Pelvic Surgery · taxonomy 2088F0040X
- **Also known as:** Jackson Clinic Urogynecology (Doing Business As); Jackson Clinic Urogynecology - Clanton (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kelin Penney, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 1722 PINE ST STE 503, Montgomery, AL 36106-1160
- **Phone:** (334) 293-8736 · **Fax:** (334) 293-8738
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 247 clinicians in 26 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (86), Internal Medicine (39), Family Practice (26); 57 practice at this address and 167 within 10 miles; [full list](https://npiprofile.com/npi/1205494416/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1205494416) · Data from the CMS NPPES public registry.