NPIMap

Organization Active NPI

Jackson Hospital and Clinic, Inc.

  • Hospitalist Physician
  • Montgomery, AL
National Provider Identifier
1306229190
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
JACKSON HOSPITAL AND CLINIC, INC.
Practice address
1725 Pine St
Montgomery, AL 36106-1109
Phone
(334) 293-8016
NPI assigned
Jun 30, 2015
Organization subpart
No

Practitioners 40

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

View all 40

Medicare participation

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

Enrollment records 1

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 Delfabbro71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anita D Hayslip
Title
Division Director Revenue Cycle
Phone
(334) 293-8128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1109

Mailing address

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 293-8016

NPI Registry JSON

The complete record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1306229190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-293-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-293-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOSPITAL AND CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "HAYSLIP",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIVISION DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "334-293-8128"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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.