Charles C Jenkins, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G9096 Issued in CA

Practice address

700 River Dr
Fort Bragg, CA 95437-5403

Phone

(707) 961-1234

Fax

(707) 964-3691

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

General Surgery

Education

Stanford University School of Medicine, 1962

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ukiah Adventist HospitalGroup PAC ID 6406816123, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Merit-based Incentive Payment System (MIPS)

Final score

88.16 of 100Reported as group

Quality

82.56

Promoting interoperability

93

Improvement activities

40

Cost

69.49

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Medicare reassignment Care Compare group NPD
• Ukiah Adventist Hospital

  • Community/Retail Pharmacy
  • Willits, CA
  • NPI 1629432968
  NPD
• First Surgical Consultants Medical Group Inc

  • Specialist
  • Oakland, CA
  • NPI 1922031525
  NPD (past)

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

• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1205928660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 375",
            "city": "MENDOCINO",
            "state": "CA",
            "postal_code": "954600375",
            "telephone_number": "510-918-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RIVER DR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "707-961-1234",
            "fax_number": "707-964-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G9096",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G9096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922031525",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mei Lin M Jackson
• Linda K James, M.D.
• Ann Kathleen Jamgochian, FNP
• Jason D Moore
• Richard William Jaulus, LCSW
• John a. Kermen, D.O.
• Marty Christine Johnson, L.M.F.T. CA.
• Georgina Jones, RPT
• Joseph Beeney PH D Psychologist Inc
• Madhup Joshi, MD

• Surgery Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.