Active NPI
Gerald P. Jenkins, DMIN
- Marriage & Family Therapist
- Cumming, GA
National Provider Identifier
1073664967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT000318
- Practice address
- 634 Peachtree Pkwy
Suite 210
Cumming, GA 30041-9782 - Phone
- (678) 513-7676
- Fax
- (770) 844-0561
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT000318 | GA | Primary |
Addresses
Primary practice location
634 Peachtree Pkwy
Suite 210
Cumming, GA 30041-9782
Mailing address
2536 Ballantrae Cir
Cumming, GA 30041-6393
Phone (770) 844-0794
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 |
|---|---|---|---|
| MFT000318 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073664967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2536 BALLANTRAE CIR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300416393",
"telephone_number": "770-844-0794",
"fax_number": "770-844-0561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 PEACHTREE PKWY",
"address_2": "SUITE 210",
"city": "CUMMING",
"state": "GA",
"postal_code": "300419782",
"telephone_number": "678-513-7676",
"fax_number": "770-844-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "GERALD",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "DMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "MFT000318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.