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JACKSON HOSPITAL & CLINIC, INC.
NPI 1235667544
Obstetrics & Gynecology in Tallassee, AL

Active since May 31, 2017CLIA 01D2095589 · Waiver
80 HERREN HILL RD STE C, TALLASSEE, AL 36078(334) 284-1500(334) 288-7763 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, May 31, 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 1235667544), doing business as Jackson Clinic Obgyn Tallassee, is a healthcare organization registered as an obstetrics & gynecology in Tallassee, Alabama and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through May 8, 2027 and lists Kelin Penney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1235667544
Entity TypeOrganization
Primary Taxonomy207V00000X
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) 240-2337 · Fax (334) 293-8738
Phone(334) 284-1500
Fax(334) 288-7763
Organization SubpartNo
Authorized OfficialKelin PenneyExecutive Director · (334) 240-2335
Enumeration DateMay 31, 2017
Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1235667544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
80 HERREN HILL RD STE C, Tallassee, AL 36078
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Other Names 1

Doing Business AsJackson Clinic Obgyn Tallassee

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

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 01D2095589

Jackson Hospital & Clinic Inc · Montgomery, AL
Active · expires May 8, 2027
CLIA Number01D2095589
Laboratory TypePhysician Office
Certificate Effective DateMay 9, 2025
Certificate Expiration DateMay 8, 2027
Laboratory DirectorLatoya Clark MD
Laboratory Phone(334) 284-1500
Laboratory LocationJackson Hospital & Clinic Inc1758 Park Place Suite 301, Montgomery, AL 36106
CLIA data matches this NPI record on: Name 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.
Urology
80 HERREN HILL RD STE C
TALLASSEE, AL 36078
Elmore County (334) 293-8588
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 1235667544. It was assigned to this organization in the NPPES registry on May 31, 2017. The provider is doing business as Jackson Clinic OBGYN 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) 284-1500.

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

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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

Yes. A Certificate of Waiver (number 01D2095589) is associated with this NPI, valid through May 8, 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 & Clinic, Inc. was last updated on March 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.