JACKSON HOSPITAL AND CLINIC, INC
NPI 1508533506
Family Medicine in Pike Road, AL

Active since August 26, 2021CLIA 01D2247871 · Waiver
9521 VAUGHN RD, PIKE ROAD, AL 36064(334) 293-8736 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 9, 2026, Aug 26, 2021 (2 updates tracked since 2021).

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 1508533506), doing business as Jackson Pike Road Urgent Care, is a healthcare organization registered as a family medicine in Pike Road, Alabama and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Kelin Penney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1508533506
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJACKSON HOSPITAL AND CLINIC, INC
Location Address9521 VAUGHN RDPike Road, AL 36064-2292
Mailing Address1722 Pine St Ste 804Montgomery, AL 36106-1108 · (334) 293-8736 · Fax (334) 293-8738
Organization SubpartNo
Authorized OfficialKelin PenneyExecutive Director · (334) 240-2335
Enumeration DateAugust 26, 2021
Last NPPES UpdateMarch 9, 20262 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1508533506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9521 VAUGHN RD, Pike Road, AL 36064

Other Names 1

Doing Business AsJackson Pike Road Urgent Care

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 Hospital And Clinic, Inc 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 Hospital And Clinic, Inc, which bills Medicare for the services they deliver. Of these, 41 practice 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
Nurse Practitioner
NPI 1497273395
11123 CHANTILLY PKWY CT UNIT M
Pike Road, AL 36064
(334) 832-2301
✔ PECOS✔ Accepts Medicare1.9 mi
Family Practice
NPI 1275775165
11123 CHANTILLY PKWY CT SUITE M
Pike Road, AL 36064
(334) 832-2301
✔ PECOS✔ Accepts Medicare1.9 mi
Nurse Practitioner
NPI 1548809916
3186 PARLIAMENT CIR STE 902
Montgomery, AL 36116
(334) 416-8298
✔ PECOS✔ Accepts Medicare4.1 mi
Nurse Practitioner
NPI 1114244456
2060 BERRYHILL RD
Montgomery, AL 36117
(334) 676-3366
✔ PECOS✔ Accepts Medicare4.2 mi
Vascular Surgery
NPI 1801916788
7085 SYDNEY CURV
Montgomery, AL 36117
(334) 246-4774
✔ PECOS✔ Accepts Medicare4.7 mi
Nurse Practitioner
NPI 1407383268
2257 TAYLOR RD
Montgomery, AL 36117
(334) 245-6605
✔ PECOS✔ Accepts Medicare4.9 mi
Nurse Practitioner
NPI 1821467267
488 SAINT LUKES DR
Montgomery, AL 36117
(334) 288-7808
✔ PECOS✔ Accepts Medicare5.0 mi
Nurse Practitioner
NPI 1578195871
488 SAINT LUKES DR
Montgomery, AL 36117
(334) 288-7808
✔ PECOS✔ Accepts Medicare5.0 mi
Nurse Practitioner
NPI 1043671951
488 SAINT LUKES DR
Montgomery, AL 36117
(334) 288-7808
✔ PECOS✔ Accepts Medicare5.0 mi
Physical Therapist in Private Practice
NPI 1285679746
454 TAYLOR RD
Montgomery, AL 36117
(334) 613-9000
✔ Accepts Medicare5.0 mi
Nurse Practitioner
NPI 1649635079
470 TAYLOR RD STE 310
Montgomery, AL 36117
(334) 747-4322
✔ PECOS✔ Accepts Medicare5.0 mi
General Surgery
NPI 1720181886
470 TAYLOR RD STE 202
Montgomery, AL 36117
(334) 244-6773
✔ PECOS✔ Accepts Medicare5.0 mi
Urology
NPI 1730323056
470 TAYLOR RD STE 201
Montgomery, AL 36117
(334) 747-9720
✔ PECOS✔ Accepts Medicare5.0 mi
Family Practice
NPI 1750342556
448 SAINT LUKES DR
Montgomery, AL 36117
(334) 288-7808
✔ PECOS✔ Accepts Medicare5.0 mi
Otolaryngology
NPI 1386752723
350 TAYLOR RD STE 2200
Montgomery, AL 36117
(334) 747-7500
✔ PECOS✔ Accepts Medicare5.0 mi
Interventional Cardiology
NPI 1891985263
273 WINTON M BLOUNT LOOP
Montgomery, AL 36117
(334) 280-1500
✔ PECOS✔ Accepts Medicare5.1 mi
Cardiovascular Disease (Cardiology)
NPI 1053341024
273 WINTON M BLOUNT LOOP
Montgomery, AL 36117
(334) 280-1500
✔ PECOS5.1 mi
Emergency Medicine
NPI 1245226612
215 WINTON M BLOUNT LOOP
Montgomery, AL 36117
(334) 239-9480
✔ PECOS✔ Accepts Medicare5.2 mi
Pulmonary Disease
NPI 1831150259
3500 EASTERN BLVD STE 110
Montgomery, AL 36116
(334) 398-2334
✔ PECOS✔ Accepts Medicare8.1 mi
Internal Medicine
NPI 1861459703
4212 CARMICHAEL CT N
Montgomery, AL 36106
(334) 213-8804
✔ PECOS✔ Accepts Medicare8.3 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.

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 01D2247871

Jackson Hospital And Clinic · Pike Road, AL
Active · expires Sep 30, 2027
CLIA Number01D2247871
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorChristopher Waguespack
Laboratory Phone(334) 523-6047
Laboratory LocationJackson Hospital And Clinic9521 Vaughn Road, Pike Road, AL 36064
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 1508533506. It was assigned to this organization in the NPPES registry on August 26, 2021. The provider is doing business as Jackson Pike Road Urgent Care.

Where is Jackson Hospital And Clinic, Inc located?

Jackson Hospital And Clinic, Inc is located at 9521 Vaughn Rd, Pike Road, AL 36064. 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 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, 41 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 Waiver (number 01D2247871) is associated with this NPI, valid through September 30, 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.