Active NPI
Jordan Jenkins
- Physical Therapist
- Clinton, MS
National Provider Identifier
1053039388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT7422
- Practice address
- 501 E Northside Dr
Clinton, MS 39056-3604 - Phone
- (601) 924-0645
- Fax
- (601) 607-1375
- NPI assigned
- Aug 22, 2022
- Last updated
- Aug 22, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT7422 | MS | Primary |
Addresses
Primary practice location
501 E Northside Dr
Clinton, MS 39056-3604
Mailing address
599C Steed Rd
Ridgeland, MS 39157-1707
Phone (601) 605-6777
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 |
|---|---|---|---|
| PT7422 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1053039388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "599C STEED RD",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391571707",
"telephone_number": "601-605-6777",
"fax_number": "601-813-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E NORTHSIDE DR",
"city": "CLINTON",
"state": "MS",
"postal_code": "390563604",
"telephone_number": "601-924-0645",
"fax_number": "601-607-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT7422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.