Individual provider Active NPI

David M. Jenkinson, DO

  • Sports Medicine (Family Medicine) Physician
  • Swansea, SC
National Provider Identifier
1104812874
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
35705 Issued in SC
Practice address
935 W 2ND St
Swansea, SC 29160-8665
Phone
(803) 568-2000
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 1487 TN
Sports Medicine (Family Medicine) Physician 207QS0010X 35705 SC Primary

Addresses

Primary practice location

935 W 2ND St
Swansea, SC 29160-8665

Mailing address

PO Box 896239
Charlotte, NC 28289-6239
Phone (803) 568-2000

Other identifiers 1

IdentifierTypeStateIssuer
357055MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130823001158 SC Practitioner - Sports MedicinePractitioner - Family Practice 6901853829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aiken Professional Association LLCGroup PAC ID 0446430805, 55 clinicians

Practice addresses (Care Compare)

4211 Trolley Line Rd
Aiken, SC 29801-2749
Phone (803) 306-7733

Hospital & facility affiliations

  • Trinity Home Health of Aiken Home health agency, Aiken, SC, CCN 427119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1487TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Professional Association LLC CurrentSince Dec 21, 2023 Accepting new patients
Aiken Professional Association, LLC CurrentSince Dec 21, 2023 Accepting new patients
Sports Care of Chattanooga PLLC Sports Medicine Past Accepting new patients
Emergency Physicians PC Past Accepting new patients
Crossroads Urgent Care PLLC Past Accepting new patients
University of Pittsburgh Physicians Past Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients

Locations

4211 Trolley Line Rd
Aiken, SC 29801
Phone (803) 306-7733

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

121 Aurora Pl
Ste B
Aiken, SC 29801
Phone (803) 306-7733

410 University Pkwy
Ste 1550A
Aiken, SC 29801
Phone (803) 306-7733

Organizations & group practices 7

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 1

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104812874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896239",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896239",
            "telephone_number": "803-568-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 W 2ND ST",
            "city": "SWANSEA",
            "state": "SC",
            "postal_code": "291608665",
            "telephone_number": "803-568-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINSON",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "1487",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "35705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357055",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, SC

Sources for this page

Verify at the official NPI Registry.