NPIMap

Individual provider Active NPI

Chester W Jenkins, MD

  • Psychiatry Physician
  • Greenville, MS
National Provider Identifier
1184622201
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15598 Issued in MS
Practice address
300 S Washington Ave
Greenville, MS 38701-4719
Phone
(662) 725-1025
Fax
(662) 725-1023
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X N8305 AR
Psychiatry Physician 2084P0800X 15598 MS Primary
Psychiatry Physician 2084P0800X MD0000029544 TN
Psychiatry Physician 2084P0800X 00005814 AL
Psychiatry Physician 2084P0800X 012716 GA

Addresses

Primary practice location

300 S Washington Ave
Greenville, MS 38701-4719

Mailing address

PO Box 4739
Greenville, MS 38704-4739
Phone (662) 725-2749

Other identifiers 2

IdentifierTypeStateIssuer
02472042MedicaidMS
121968001MedicaidAR

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5814ALMDEndodontist
00005814ALMDPsychiatry Physician
N8305ARMDPsychiatry Physician
012716GAMDPsychiatry Physician
15598MSMDPsychiatry Physician
MD0000029544TNMDPsychiatry Physician
3069ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
David D Hall DO PC PastSince Jul 28, 2012 Accepting new patients
Behavioral Medicine LLC Past Accepting new patients
Garden Park Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Montgomery Area Mental Health Authority Inc Past Accepting new patients
Montgomery Area Mental Health Authority Inc PastSince Feb 4, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/carastar/r4/

Organizations & group practices 6

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1184622201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4739",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044739",
            "telephone_number": "662-725-2749",
            "fax_number": "662-725-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S WASHINGTON AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014719",
            "telephone_number": "662-725-1025",
            "fax_number": "662-725-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHESTER",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "N8305",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "15598",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000029544",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00005814",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "012716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02472042",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121968001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.