JACKSON HOSPITAL AND CLINIC, INC
NPI 1215519418
Family Medicine in Deatsville, 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 1215519418), doing business as Jackson Family Medicine Pine Level, is a healthcare organization registered as a family medicine in Deatsville, Alabama and active in the NPI registry since April 2021. The organization holds an CLIA Accreditation certificate valid through November 19, 2027 and lists Kelin Penney, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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, 11 practice 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 247Montgomery, AL 36112
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Accreditation 01D2104538
Jackson Hospital & Clinic, Inc · Deatsville, ALFrequently 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 1215519418. It was assigned to this organization in the NPPES registry on April 27, 2021. The provider is doing business as Jackson Family Medicine Pine Level.
Where is Jackson Hospital And Clinic, Inc located?
Jackson Hospital And Clinic, Inc is located at 2175 Us Highway 31 N, Deatsville, AL 36022. The listed phone number is (334) 568-2120.
What is Jackson Hospital And Clinic, Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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, 11 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jackson Hospital And Clinic, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 01D2104538) is associated with this NPI, valid through November 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
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 1215519418
Family Medicine organization in Deatsville, Alabama. Organization record, active in the CMS NPPES registry since April 27, 2021.
## Identity
- **NPI:** 1215519418 (Entity type: Organization)
- **Enumerated:** April 27, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Jackson Family Medicine Pine Level (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kelin Penney, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 2175 US HIGHWAY 31 N, Deatsville, AL 36022-2714
- **Phone:** (334) 568-2120
## 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); 11 practice within 10 miles; [full list](https://npiprofile.com/npi/1215519418/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 9, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215519418) · Data from the CMS NPPES public registry.