NPIMap

Individual provider Active NPI

Kristopher K McJenkin, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1255779351
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6086 Issued in GA
Practice address
105 Bass Plantation Dr
Apt 607
Macon, GA 31210-5735
Phone
(770) 355-2152
Fax
(770) 355-2152
NPI assigned
Jun 11, 2013
Last updated
Sep 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6086 GA Primary

Addresses

Primary practice location

105 Bass Plantation Dr
Apt 607
Macon, GA 31210-5735

Mailing address

535 Coliseum Dr Ste B
Macon, GA 31217-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20161108002237 GA Practitioner - Family Practice 7810299906 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Hospitalist Group LLCGroup PAC ID 2769813906, 48 clinicians
Southland Bainbridge Hospitalist Group, LLCGroup PAC ID 7214248335, 54 clinicians
Dodge County Hospital AuthorityGroup PAC ID 1759372733, 14 clinicians

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

462 E G Miles Pkwy
Hinesville, GA 31313-4000
Phone (912) 369-9400

901 Griffin Ave
Eastman, GA 31023-6720
Phone (478) 374-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6086GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anemonefish Inpatient Services LLC CurrentSince Sep 29, 2016 Accepting new patients
Cogent Healthcare of Macon, LLC Family Medicine CurrentSince May 9, 2017 Accepting new patients
Southland Taylor Hospitalist Group, LLC CurrentSince Nov 1, 2025 Accepting new patients
Dodge County Hospital Authority Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Southland Bainbridge Hospitalist Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Gwinnett Physician Group, LLC Family Medicine CurrentSince Jan 23, 2022 Accepting new patients
Dodge County Hospital Authority CurrentSince Jul 1, 2025 Accepting new patients
Houston Hospitalist Group LLC CurrentSince Jan 20, 2022 Accepting new patients
Houston Hospitalist Group LLC CurrentSince Jan 20, 2022 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients
Hospital Authority of Liberty County Past Accepting new patients
Houston Hospitals Inc Past Accepting new patients

Locations

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

777 Hemlock St
#104
Macon, GA 31201
Phone (478) 633-7550

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: kristopher.mcjenkin@qhs.gadirect.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1255779351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 COLISEUM DR STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312170106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BASS PLANTATION DR",
            "address_2": "APT 607",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105735",
            "telephone_number": "770-355-2152",
            "fax_number": "770-355-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCJENKIN",
        "first_name": "KRISTOPHER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "6086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.