Active NPI
Judy K Jenkins, LPN
- Licensed Practical Nurse
- Mount Vernon, IL
National Provider Identifier
1003133539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043074868
- Practice address
- 2920 Veterans Memorial Dr
Mount Vernon, IL 62864-5924 - Phone
- (618) 244-6544
- Fax
- (618) 244-6577
- NPI assigned
- Apr 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043074868 | IL | Primary |
Addresses
Primary practice location
2920 Veterans Memorial Dr
Mount Vernon, IL 62864-5924
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436
Other names 1
- Judy K West
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043074868 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271980800000",
"number": "1003133539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 155",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "628220155",
"telephone_number": "618-724-2436",
"fax_number": "618-724-2571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 VETERANS MEMORIAL DR",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628645924",
"telephone_number": "618-244-6544",
"fax_number": "618-244-6577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JUDY",
"middle_name": "K",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-23",
"last_updated": "2010-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043074868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUDY",
"last_name": "WEST",
"middle_name": "K",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.