JACKSON HOSPITAL & CLINIC, INC.
NPI 1235667544
Obstetrics & Gynecology in Tallassee, AL
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
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 & 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 & Clinic, Inc., which bills Medicare for the services they deliver. Of these, 2 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 36106
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 Waiver 01D2095589
Jackson Hospital & Clinic Inc · Montgomery, 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 & 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.
Is Jackson Hospital & Clinic, Inc. enrolled in Medicare?
Yes. Jackson Hospital & Clinic, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jackson Hospital & 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 & 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 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 & Clinic, Inc. · NPI 1235667544
Obstetrics & Gynecology organization in Tallassee, Alabama. Organization record, active in the CMS NPPES registry since May 31, 2017.
## Identity
- **NPI:** 1235667544 (Entity type: Organization)
- **Enumerated:** May 31, 2017
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **Also known as:** Jackson Clinic OBGYN Tallassee (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kelin Penney, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 80 HERREN HILL RD STE C, Tallassee, AL 36078-1264
- **Phone:** (334) 284-1500 · **Fax:** (334) 288-7763
## 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); 2 practice within 10 miles; [full list](https://npiprofile.com/npi/1235667544/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/1235667544) · Data from the CMS NPPES public registry.