Individual provider Active NPI

Morgan Jenkins, M.D.

  • Pediatrics Physician
  • Clermont, FL
National Provider Identifier
1124194980
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME129312 Issued in FL
Practice address
16709 Kamalin CT
Clermont, FL 34715-9519
Phone
(352) 989-0576
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G57608 CA
General Practice Physician 208D00000X ME129312 FL
General Practice Physician 208D00000X G57608 CA
Pediatrics Physician 208000000X ME129312 FL Primary

Addresses

Primary practice location

16709 Kamalin CT
Clermont, FL 34715-9519

Mailing address

PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (302) 651-6212

Other practice location 1

16709 Kamalin Ct
Clermont, FL 34715-9519
Phone (352) 989-0576

Other identifiers 1

IdentifierTypeStateIssuer
019353800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170503002518 FL Practitioner - Pediatric Medicine 4082807581 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57608CAMDGeneral Practice Dentistry
G57608CAMDPediatrics Physician
ME129312FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Mar 18, 2017 Accepting new patients
The Nemours Foundation CurrentSince Mar 18, 2017 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1481 Wp Ball Blvd
Sanford, FL 32771
Phone (321) 843-5703

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1124194980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16709 KAMALIN CT",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347159519",
            "telephone_number": "352-989-0576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16709 Kamalin Ct",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347159519",
            "country_code": "US",
            "telephone_number": "352-989-0576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MORGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G57608",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME129312",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G57608",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME129312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019353800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.