NPIMap

Individual provider Active NPI

Loni Elise Jenkins, MD

  • Family Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1053515338
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
063358 Issued in GA
Practice address
3579 Highway 138 SE
Suite 101
Stockbridge, GA 30281-4142
Phone
(770) 507-0029
Fax
(770) 507-9990
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 141367 NC
Family Medicine Physician 207Q00000X 063358 GA Primary

Addresses

Primary practice location

3579 Highway 138 SE
Suite 101
Stockbridge, GA 30281-4142

Mailing address

1065 Jodeco Rd
Stockbridge, GA 30281-4953
Phone (678) 284-6300

Other identifiers 2

IdentifierTypeStateIssuer
141367OtherNCRESIDENT TRAINING LICENSE
806901621AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000270 GA Practitioner - Family Practice 0648464842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
141367NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Mar 2, 2012 Accepting new patients
The Emory Clinic Inc CurrentSince May 9, 2020 Accepting new patients
Emory Health Care Past Accepting new patients
The Doctor's Office, LLC Family Medicine Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

3000 Shakerag Hl
Peachtree Cty, GA 30269
Phone (478) 994-0437

3579 Highway 138 SE
Ste 101
Stockbridge, GA 30281
Phone (770) 507-0029

Interoperability endpoints

  • Direct secure messaging: ljenkins42945@direct.emory.org

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1053515338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 JODECO RD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814953",
            "telephone_number": "678-284-6300",
            "fax_number": "678-284-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 HIGHWAY 138 SE",
            "address_2": "SUITE 101",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814142",
            "telephone_number": "770-507-0029",
            "fax_number": "770-507-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LONI",
        "middle_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "141367",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "063358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT TRAINING LICENSE",
            "identifier": "141367",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806901621A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.