NPIMap

Individual provider Active NPI

Marcus Jenkins, MD

  • Anesthesiology Physician
  • Riverdale, GA
National Provider Identifier
1194700708
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D47952 Issued in MD
Practice address
170 Longcreek Dr
Riverdale, GA 30296-1046
Phone
(678) 817-7494
Fax
(678) 817-7495
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 9

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.

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
D47952MDMDAnesthesiology Physician
3801GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Anesthesia Associates LLC Anesthesiology Past Accepting new patients
Progressive Anesthesia Consultants, LLC Anesthesiology Past Accepting new patients
Amsol Physicians of Columbus Ga Anesthesiology Past Accepting new patients
Northwest Allied Anesthesia Inc Past Accepting new patients
New London Anesthesia & Pain Consultants PC Anesthesiology Past Accepting new patients
Piedmont Anesthesia Associates, L.L.C Anesthesiology Past Accepting new patients
Advanced Anesthesia Associates, PC Anesthesiology Past Accepting new patients
Fayette Community Anesthesia Anesthesiology Past Accepting new patients
Amsol Physicians of Columbus Ga LLC Anesthesiology Past Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D47952 MD Primary
Anesthesiology Physician 207L00000X 48058 GA

Addresses

NPPES NPI Registry

Primary practice location

170 Longcreek Dr
Riverdale, GA 30296-1046

Mailing address

170 Longcreek Dr
Riverdale, GA 30296-1046
Phone (678) 817-7494

Other practice location 1

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (470) 644-1274

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address mjenkins515205@directwellstar.org Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 11, 2023.

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1194700708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 LONGCREEK DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961046",
            "telephone_number": "678-817-7494",
            "fax_number": "678-817-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 LONGCREEK DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961046",
            "telephone_number": "678-817-7494",
            "fax_number": "678-817-7495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "470-644-1274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARCUS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D47952",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "48058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjenkins515205@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2540 Windy Hill Rd SE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300678605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.