Modena Jenkins, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05401 Issued in KS

Practice address

434 N Ohio Ave
Wichita, KS 67214-3938

Phone

(316) 409-6626

Fax

(316) 776-4479

NPI assigned

Oct 14, 2015

Last updated

Apr 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dena Jenkins Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1023489275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N OHIO AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143938",
            "telephone_number": "316-409-6626",
            "fax_number": "316-776-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N OHIO AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143938",
            "telephone_number": "316-409-6626",
            "fax_number": "316-776-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MODENA",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9524",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201121550B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENA",
            "last_name": "JENKINS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Irma Rae Jeffries, LMSW
• Joseph Jenkins Saffold, MD
• Deann Jenkins, MD
• Demetria Jenkins
• Jodi Jenkins, RN
• Jenna Dahms Lscsw LLC
• Spencer Jenne, DMD
• Anna Ruth Jenney
• Jenni Harshbarger, PHD, P.a.
• Jennifer Gennaro Prokopchik

• Clinical Social Worker in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.