NPIMap

Organization Active NPI

Jackson Hospital & Clinic, Inc.

  • Physical Therapist
  • Montgomery, AL
National Provider Identifier
1265325823
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JACKSON HOSPITAL & CLINIC, INC.
Practice address
1722 Pine St Ste 602
Montgomery, AL 36106-1114
Phone
(334) 293-8736
Fax
(334) 293-8738
NPI assigned
Jun 2, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kelin Penney
Title
Executive Director
Phone
(334) 240-2335

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners 259

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040414000971 AL Part B Supplier - Clinic/Group Practice 0547254153 Receives reassigned benefits from 247 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Egidio G Delfabbro (71 organizations share this tax ID)

Locations

1050 Bailey Dr
Demopolis, AL 36732
Phone (334) 289-5030

1508 Mulberry St
Montgomery, AL 36106
Phone (334) 293-8820

4154 Carmichael Rd
Montgomery, AL 36106
Phone (334) 271-5959

1725 Park Pl
Ste 202
Montgomery, AL 36106
Phone (334) 281-7666

1801 Pine St
Ste 101
Montgomery, AL 36106
Phone (334) 293-8138

2257 Taylor Rd
Ste 200
Montgomery, AL 36117
Phone (334) 270-9914

1725 Park Pl
#300A
Montgomery, AL 36106
Phone (334) 293-8922

1722 Pine St
Ste 203
Montgomery, AL 36106
Phone (334) 271-1263

1722 Pine St
Ste 900
Montgomery, AL 36106
Phone (334) 264-0222

1722 Pine St
Ste 602
Montgomery, AL 36106

1801 Pine St
Ste 203
Montgomery, AL 36106
Phone (334) 240-2334

11123 Chantilly Pkwy Ct
Pike Road, AL 36064
Phone (334) 270-1151

805 Friendship Rd
Ste B
Tallassee, AL 36078

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1722 Pine St Ste 602
Montgomery, AL 36106-1114

Mailing address

1722 Pine St Ste 804
Montgomery, AL 36106-1108
Phone (334) 293-8736

Other names 1

NPPES NPI Registry
  • Jackson Pelvic Floor Therapy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 9, 2026.

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1265325823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 PINE ST STE 804",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061108",
            "telephone_number": "334-293-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PINE ST STE 602",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061114",
            "telephone_number": "334-293-8736",
            "fax_number": "334-293-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOSPITAL & CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-02",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "PENNEY",
        "authorized_official_first_name": "KELIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "334-240-2335"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Pelvic Floor Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.