Individual provider Active NPI

Fridea Jenkins, MSN, APRN, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Macon, GA
National Provider Identifier
1174489603
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
PMH01260019 Issued in GA
Practice address
786 Ivy Brook Way
Macon, GA 31210-5528
Phone
(478) 952-9984
NPI assigned
Dec 29, 2025
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X PMH01260019 GA Primary

Addresses

Primary practice location

786 Ivy Brook Way
Macon, GA 31210-5528

Mailing address

786 Ivy Brook Way
Macon, GA 31210-5528
Phone (478) 952-9984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
PMH01260019GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Psychiatric Center, LLC CurrentSince Jan 4, 2026 Accepting new patients

Locations

3100 Ridge Ave
Macon, GA 31204
Phone (478) 233-5694

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1174489603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 IVY BROOK WAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105528",
            "telephone_number": "478-952-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 IVY BROOK WAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105528",
            "telephone_number": "478-952-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "FRIDEA",
        "credential": "MSN, APRN, PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "PMH01260019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.