Jennifer L. Jenks, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

219148 Issued in MA

Practice address

410 Sunset Rd
Ann Arbor, MI 48103-2915

Phone

(734) 531-6933

Fax

(734) 506-2491

NPI assigned

May 19, 2006

Last updated

Mar 18, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 11, 2017 through Apr 11, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sustain Physical Therapy and Performance

  • Physical Therapy Clinic/Center
  • Boston, MA
  • NPI 1144745902
  NPD (past)
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Marlborough, MA
  • NPI 1396738159
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1215980057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4468 AUGUSTA CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089789",
            "telephone_number": "617-513-5859",
            "fax_number": "734-506-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SUNSET RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032915",
            "telephone_number": "734-531-6933",
            "fax_number": "734-506-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "219148",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "219148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Jeffries, M.D.
• Annalise Diane Jencson, PHARMD
• Ian Jenkins, MD
• Lauren Nicole Jenkins, M.A. BCBA
• Michelle Jenkins
• Jenna McAfee PHD LLC
• Kimberly R Jenne
• Jennifer Culver, PH.D., LLC
• Jennifer Perrone LMSW PLLC
• Jennifer Ratliff-Moss LMSW, LLC

• Child & Adolescent Psychiatry Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.