Jaletha Jenkins, LBSW

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

2004 Fremont St
South Bend, IN 46628-3153

Phone

(317) 296-5382

NPI assigned

Sep 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• The Crown Beauty Collection

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1356270367
  NPD Authorized official

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1114703303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 N KEYSTONE AVE STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202499",
            "telephone_number": "317-296-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 FREMONT ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466283153",
            "telephone_number": "317-296-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JALETHA",
        "name_prefix": "Mrs.",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33900285A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S. Mader, DDS, LLC
• Abisola Jegede, DMD, MPH
• Donald Michael Jellison, BCBA
• Anastaisha Nicole Jenkins
• Erin Jenkins, LCSW
• John L Jenkins, M.D.
• Kelly Jenkins
• Rashe Tywan Jenkins
• Kristine Elizabeth Jennings, MD
• Rachel Ann Jennings, NP

• All providers in South Bend, IN
• Prosthetic/Orthotic Supplier in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.