Randon Carl Jenkins

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704273274 Issued in MI

Practice address

4669 E 8 Mile Rd
Warren, MI 48091-2709

Phone

(313) 416-6262

NPI assigned

Mar 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sami Abu Farha MD PCGroup PAC ID 2264486372, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEHDBA/Endpoint/GEHDBA

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.

• Sami Abu Farha MD PC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1073664843
  Medicare reassignment Care Compare group NPD

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

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1520035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1093217218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6547 WINDMILL LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243759",
            "telephone_number": "313-516-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4669 E 8 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912709",
            "telephone_number": "313-416-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "RANDON",
        "middle_name": "CARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-03",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704273274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Jeffery, LMSW
• Jeffrey K Wingate MD PLLC
• Jeffrey K. Wingate, M.D.
• Jeffrey Schwalb
• Deshawnda Jenkins
• Tyaira Jenkins
• Deja Jennings
• Daniel Loran Jensen, DO
• John Jerius, MD
• Victoria Ashley Jeross, LLMSW

• Gerontology Nurse Practitioner in Warren, MI
• Providers in Warren, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.