Jesus and Mary Church

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JESUS AND MARY CHURCH

Practice address

14970 Potomac Heights PL Apt 113
Woodbridge, VA 22191-6261

Phone

(929) 410-5754

NPI assigned

Apr 2, 2026

Organization subpart

No

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

Authorized official

Name

Sergio Bolanos

Title

Ceo

Phone

(929) 410-5754

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1104767425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14970 POTOMAC HEIGHTS PL APT 113",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14970 POTOMAC HEIGHTS PL APT 113",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916261",
            "telephone_number": "929-410-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS AND MARY CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "BOLANOS",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "929-410-5754"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin N. Jenkins, M. ED.
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• Durable Medical Equipment & Medical Supplies in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.