Jackson Wellness Center – Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician, NPI 1205494416

Jackson Wellness Center is a healthcare provider. based in Montgomery, Alabama. specializing in Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician. The NPI Number for Jackson Wellness Center is 1205494416

Main info

Organization
Name
Jackson Wellness Center
NPI
1205494416
Phone
(334) 293-8736
Address
1722 PINE ST STE 804
Authorized Official
KELIN PENNEY EXECUTIVE DIRECTOR
Enumeration Date
3 June 2019
Last Update Date
9 March 2026

Contacts

Secure Messaging
tara.herring@jackson.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness100
Years active:7State licenses:07/7 NPPES fields on file

Provider Addresses for Jackson Wellness Center

  • 1722 PINE ST STE 804

    MONTGOMERY, AL 361061108

    Phone: (334) 293-8736

    Fax: (334) 293-8738

    Type: Mailing

  • 2030 Lay Dam Rd

    Clanton, AL 350458344

    Phone: (334) 293-8736

    Fax: (334) 293-8738

    Type: Location

  • 7150 Halcyon Park Dr

    Montgomery, AL 361177713

    Phone: (334) 293-8736

    Fax: (334) 293-8738

    Type: Location

  • 503, Pine Street, Royersford, Montgomery County, Pennsylvania, 19468, United States

    MONTGOMERY, AL 361061160

    Phone: (334) 293-8736

    Fax: (334) 293-8738

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36106)

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Frequently asked questions

Is Jackson Wellness Center listed with a National Provider Identifier?
Yes — Jackson Wellness Center has NPI 1205494416 on file in the registry.
Is there an active status for Jackson Wellness Center?
For scheduling context, Jackson Wellness Center is shown as active in the registry.
What expertise is attributed to Jackson Wellness Center?
Jackson Wellness Center's specialty line reads Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Jackson Wellness Center?
Directory geography for Jackson Wellness Center centers on Montgomery, Alabama.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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