Kerry Jenkins, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101302 Issued in FL

Practice address

3000 North University Drive
Suite K
Coral Springs, FL 33065-5082

Phone

(954) 752-2630

Fax

(954) 755-1865

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1265545578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 NORTH UNIVERSITY DRIVE",
            "address_2": "SUITE K",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655082",
            "telephone_number": "954-752-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NORTH UNIVERSITY DRIVE",
            "address_2": "SUITE K",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655082",
            "telephone_number": "954-752-2630",
            "fax_number": "954-755-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "KERRY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "E5758Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey H. Lee, Edd, LMFT & Associates, PA
• Jeffrey I Haber MD PA
• Jeffrey J Gaier M D P a
• Jeffrey T. Haimes, M.D.
• Anthony James Jelley, MJ.S., CCC-A
• Jerald H. Ratner, M.D., P.a.
• JH Express Med Corp
• Janet Jhon
• Jim Creations LLC
• Teofilo De Jesus Jimenez-Gutierrez

• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.