Tasha Y Jenkins, M.D.
Individual provider Active NPI Family Medicine Physician · Temperance, MI
NPI 1154553154 · NPPES record last updated Feb 12, 2010
Key facts
- NPI
- 1154553154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301093861 (MI)
- Practice address
- 7302 Jackman Rd
Temperance, MI 48182-1315 - Phone
- (734) 850-8902
- NPI assigned
- Aug 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110211000265 | MI | Practitioner - Family Practice | 6709066517 | Reassigns benefits to 1 organization |
| I20240607000222 | PA | Practitioner - Family Practice | 6709066517 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301093861 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients |
Locations
13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620
600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301093861 | MI | Yes |
Addresses
Primary practice location
7302 Jackman Rd
Temperance, MI 48182-1315
Mailing address
4405 N Holland Sylvania Rd
Suite 104
Toledo, OH 43623-3529
Phone (419) 882-6784
Other providers in Temperance, MI
- Emily Holloway
- Joshua Hotaling
- Emily Rose Humphrey
- Mitchell Huss
- Michaela Jackson
- John a Crayne
- Andrew Charles Johnson
- Linda R. Johnson
- Joseph D Schwallie OD, Inc
- Navdeep Kaur
All providers in Temperance, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.