Kristine Elizabeth Jennings, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01074058A Issued in IN

Practice address

714 N Michigan St
South Bend, IN 46601-1035

Phone

(574) 647-7477

Fax

(574) 647-3655

NPI assigned

Jun 22, 2011

Last updated

Mar 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Family Practice

Education

University of Michigan Medical School, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennings@mybeacon.cernerdirect.com
• Direct secure messaging: kjennings@mybeacon.cernerdirect.com
• Direct secure messaging: kristinesmith@beaconfp.allscriptsdirect.net

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Healthlinc, Inc

  dba HealthLinc - Newton

  • Federally Qualified Health Center (FQHC)
  • Morocco, IN
  • NPI 1568354116

  Corporate Director, Corporate Officer

  CMS ownership
• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Michigan City, IN
  • NPI 1013105568

  Corporate Director, Corporate Officer

  CMS ownership

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.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group NPD
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Medical Group Sports Medicine South Bend

  • Sports Medicine (Family Medicine) Physician
  • South Bend, IN
  • NPI 1578515151
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Medical Group E. Blair Warner

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1609828946
  NPD
• Beacon Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1831149525
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Memorial Epworth Center

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Beacon Granger Hospital, A Memorial Hospital Extension

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1194011775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011035",
            "telephone_number": "574-647-7477",
            "fax_number": "574-647-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "KRISTINE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01074058A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201112360",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JENNINGS@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "714 N Michigan St",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jaletha Jenkins, LBSW
• John L Jenkins, M.D.
• Kelly Jenkins
• Rashe Tywan Jenkins
• Dawn S Jennings
• Rachel Ann Jennings, NP
• Doris E Jensen, M.D.
• David Jentz, M.D.
• Michael James Jenuwine, PH.D.
• Dustin Daniel Jesch

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.