NPIMap

Individual provider Active NPI

Shantae James Jenkins, MD, PHD

  • Internal Medicine Physician
  • North Charleston, SC
National Provider Identifier
1194923094
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30021 Issued in SC
Practice address
8471 Dorchester Rd
North Charleston, SC 29420-7381
Phone
(843) 876-2879
NPI assigned
Jul 3, 2007
Last updated
Jul 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30021 SC Primary

Addresses

Primary practice location

8471 Dorchester Rd
North Charleston, SC 29420-7381

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000109 SC Practitioner - Internal Medicine 0345435640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30021SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Curana Health of South Carolina PC Internal Medicine CurrentSince Jan 25, 2019 Accepting new patients
Fetter Health Care Network, Inc. CurrentSince Oct 7, 2017 Accepting new patients
University Medical Associates of the Medical University of South Carol Internal Medicine CurrentSince Nov 9, 2023 Accepting new patients
Coastal Inpatient Physicians, LLC Internal Medicine Past Accepting new patients
Carolina Family Care, Inc Past Accepting new patients

Locations

135 Rutledge Ave
Charleston, SC 29425
Phone (803) 569-1757

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

35 Walnut St
Charleston, SC 29403
Phone (843) 723-9477

51 Nassau St
Charleston, SC 29403

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

8992 University Blvd
Ste 300
North Charleston, SC 29406
Phone (843) 876-8279

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

255 Midland Pkwy
Summerville, SC 29485
Phone (843) 821-5005

Interoperability endpoints

  • Direct secure messaging: sjenkins452670@direct.musc.edu

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Hollywood Family Health CenterHollywood, SC, CCN 421856 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jan 1, 2014
Aug 31, 2015
Elijah Wright Family Health CenterCross, SC, CCN 421839 Federally qualified health center W-2 Managing Employee Aug 30, 2015
Fetter Health Care Network IncCharleston, SC, CCN 421044 Federally qualified health center Corporate Director
W-2 Managing Employee		 Aug 31, 2015
Aug 31, 2015

Owned or controlled facilities with NPI records 3

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1194923094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8471 DORCHESTER RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294207381",
            "telephone_number": "843-876-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SHANTAE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "30021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.