Jennifer W. Jencks, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW01282 Issued in RI

Practice address

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061

Phone

(401) 432-1000

Fax

(401) 432-1500

NPI assigned

Oct 8, 2012

Sex

Female

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 RI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Emma Pendleton Bradley Hospital

  • Psychiatric Hospital
  • Riverside, RI
  • NPI 1578768867
  Medicare reassignment NPD
• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  Medicare reassignment NPD
• Rhode Island Hospital

  • Pediatrics Physician
  • Providence, RI
  • NPI 1861420333
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  Medicare reassignment
• Emma Pendleton Bradley Hospital

  • Psychiatry Physician
  • Riverside, RI
  • NPI 1073705943
  NPD
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  NPD
• Rhode Island Hospital

  • Transplant Surgery Physician
  • Providence, RI
  • NPI 1174605208
  NPD (past)

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1063764652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PARKWAY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENCKS",
        "first_name": "JENNIFER",
        "middle_name": "W.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "ISW01282",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Therapeutics of Rhode Island LLC
• Nicole M. Interlini, LMHC
• Island Health and Rehab LLC
• Albert Jacavone, RN
• Kim Jardin, RN
• Jennifer Jeremiah, MD
• William Jiacovelli, LICSW
• Jessalyn Blakely Jianos
• Gisela Gabriela Jimenez Colon, MS
• Massiel Jimenez, MD

• Clinical Social Worker in Riverside, RI
• Providers in Riverside, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.