Active NPI
Michael Joe Jenkins
- Social Worker
- White Heath, IL
National Provider Identifier
1184102345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 56 Glenn Dr
White Heath, IL 61884-9740 - Phone
- (573) 201-7295
- NPI assigned
- Jul 31, 2018
- Last updated
- Mar 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | NU | Primary |
Addresses
Primary practice location
56 Glenn Dr
White Heath, IL 61884-9740
Mailing address
56 Glenn Dr
White Heath, IL 61884-9740
Phone (573) 201-7295
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1184102345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 GLENN DR",
"city": "WHITE HEATH",
"state": "IL",
"postal_code": "618849740",
"telephone_number": "573-201-7295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 GLENN DR",
"city": "WHITE HEATH",
"state": "IL",
"postal_code": "618849740",
"telephone_number": "573-201-7295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "MICHAEL",
"middle_name": "JOE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-31",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Heath, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.