Active NPI
Jonathan E. Jenkins
- Marriage & Family Therapist
- Brandon, MS
National Provider Identifier
1245817501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T0152
- Practice address
- 613 Marquette Rd
Brandon, MS 39042-3038 - Phone
- (601) 824-0342
- Fax
- (601) 824-0349
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T0152 | MS | Primary |
Addresses
Primary practice location
613 Marquette Rd
Brandon, MS 39042-3038
Mailing address
613 Marquette Rd
Brandon, MS 39042-3038
Phone (601) 824-0342
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0152 | MS | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1245817501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 MARQUETTE RD",
"city": "BRANDON",
"state": "MS",
"postal_code": "390423038",
"telephone_number": "601-824-0342",
"fax_number": "601-824-0349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 MARQUETTE RD",
"city": "BRANDON",
"state": "MS",
"postal_code": "390423038",
"telephone_number": "601-824-0342",
"fax_number": "601-824-0349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JONATHAN",
"middle_name": "E.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-24",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MS",
"license": "T0152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.