JACKSON HOSPITAL & CLINIC, INC.
NPI 1720599012
Otolaryngology in Montgomery, AL

Active since October 13, 2017
1111 OLIVE ST, MONTGOMERY, AL 36106(334) 834-7221(334) 241-9848 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 9, 2026, Jun 16, 2018, Oct 13, 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 1720599012), doing business as Jackson Clinic Otolaryngology, is a healthcare organization registered as an otolaryngology in Montgomery, Alabama and active in the NPI registry since October 2017. The organization lists Kelin Penney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1720599012
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameJACKSON HOSPITAL & CLINIC, INC.
Location Address1111 OLIVE STMontgomery, AL 36106-1129
Mailing Address1722 Pine St Ste 804Montgomery, AL 36106-1108 · (334) 293-8736 · Fax (334) 293-8738
Fax(334) 241-9848
Organization SubpartNo
Authorized OfficialKelin PenneyExecutive Director · (334) 240-2335
Enumeration DateOctober 13, 2017
Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1720599012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1111 OLIVE ST, Montgomery, AL 36106

Other Names 1

Doing Business AsJackson Clinic Otolaryngology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 & 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 & Clinic, Inc., which bills Medicare for the services they deliver. Of these, 22 practice at this address and 166 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
Internal Medicine
NPI 1831407964
1111 OLIVE ST
Montgomery, AL 36106
(334) 293-8888
✔ PECOSSame address
Otolaryngology
NPI 1750764221
1111 OLIVE ST
Montgomery, AL 36106
(334) 834-7221
✔ PECOS✔ Accepts MedicareSame address
Otolaryngology
NPI 1164411963
1111 OLIVE ST
Montgomery, AL 36106
(334) 834-7221
✔ PECOSSame address
Family Practice
NPI 1528268703
1111 OLIVE STREET
Montgomery, AL 36106
(334) 293-8888
✔ PECOS✔ Accepts MedicareSame address
Otolaryngology
NPI 1497174189
1111 OLIVE ST
Montgomery, AL 36106
(334) 834-7221
✔ PECOSSame address
Nurse Practitioner
NPI 1841576915
1758 PARK PL SUITE 100
Montgomery, AL 36106
(334) 265-8455
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1528475084
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1104021567
1758 PARK PL STE 401
Montgomery, AL 36106
(334) 264-9191
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1467304931
1758 PARK PL STE 401
Montgomery, AL 36106
(334) 264-9191
✔ PECOSSame address
Nurse Practitioner
NPI 1710470554
1758 PARK PL STE 406
Montgomery, AL 36106
(334) 240-2348
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1598339038
1758 PARK PL STE 201
Montgomery, AL 36106
(334) 263-3630
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1053750315
1758 PARK PL STE 100
Montgomery, AL 36106
(334) 265-8455
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1306376694
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1346566700
1758 PARK PL SUITE 406
Montgomery, AL 36106
(251) 716-4744
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1467166975
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1528690542
1758 PARK PLACE SUITE 301
Montgomery, AL 36106
(334) 240-2335
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1427875475
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
Vascular Surgery
NPI 1578790895
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1780003822
1758 PARK PL STE 301
Montgomery, AL 36106
(334) 284-1500
✔ PECOS✔ Accepts MedicareSame address
Vascular Surgery
NPI 1093992646
1758 PARK PL STE 300
Montgomery, AL 36106
(334) 293-8922
✔ PECOS✔ Accepts MedicareSame address
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.

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 1720599012. It was assigned to this organization in the NPPES registry on October 13, 2017. The provider is doing business as Jackson Clinic Otolaryngology.

Where is Jackson Hospital & Clinic, Inc. located?

Jackson Hospital & Clinic, Inc. is located at 1111 Olive St, Montgomery, AL 36106. The listed phone number is (334) 834-7221.

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

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

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, 22 practice at this address and 166 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 & 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.