Mark Randall Jennings, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01037730 Issued in IN

Practice address

2015 Jackson St
Anderson, IN 46016-4337

Phone

(765) 649-2511

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Indiana University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Anderson Hospital, Anderson, IN, CCN 150088
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• IL HMO C-SNP
• KY PPO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• OH PPO
• IL PPO Downstate
• KY PPO

Interoperability endpoints

• Direct secure messaging: mark.jennings.1@7598.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Internal Medicine

  Medicare reassignment NPD
• Henry County Memorial Hospital

  • Internal Medicine Physician
  • New Castle, IN
  • NPI 1760800155
  NPD
• Henry County Memorial Hospital

  • Family Medicine Physician
  • New Castle, IN
  • NPI 1891570537

  Internal Medicine

  NPD
• Henry County Memorial Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1952452815
  NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD
• St. Vincent Medical Group, Inc.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• St. Vincent Anderson Regional Hospital, Inc.

  • General Acute Care Hospital
  • Anderson, IN
  • NPI 1679578850
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Anderson Regional Hospital, Inc.

  • General Acute Care Hospital
  • Anderson, IN
  • NPI 1679578850
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1003915539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164337",
            "telephone_number": "765-649-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MARK",
        "middle_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01037730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100172700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jerry D Warthman, O.D., LLC
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• Jetty Heart Clinic of the Indiana Heart Hospital LLC

• Internal Medicine Physician in Anderson, IN
• Providers in Anderson, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.