Dana Jenkins, FNP
Individual provider Active NPI Adult Health Nurse Practitioner · Fort Gordon, GA
NPI 1023064359 · NPPES record last updated Oct 8, 2013
Key facts
- NPI
- 1023064359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RN117622 (GA)
- Practice address
- 300 W Hospital Rd
Connelly Health Clinic
Fort Gordon, GA 30905-5741 - Phone
- (706) 787-5161
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN117622 | GA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acute Care Consultants, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN117622 | GA | Yes |
Addresses
Primary practice location
300 W Hospital Rd
Connelly Health Clinic
Fort Gordon, GA 30905-5741
Mailing address
300 W Hospital Rd
Connelly Health Clinic
Fort Gordon, GA 30905-5741
Phone (706) 787-5161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000871406B | Medicaid | GA | |
| NPO386 | Medicaid | SC | |
| 000871406A | Medicaid | GA |
Other providers in Fort Gordon, GA
- Bonamico Porter Jacobs
- Bruce Lee James
- Jacqueline James
- Karin Macayla Jamison
- Bryan Kelly Jaye
- James A Jenkins Jr.
- Keyonna Micole Jenkins
- Chris K Jensen
- Monika Rene Jernigan
- Robert E Jeschke
All providers in Fort Gordon, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.