Ruth Jenkins

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20009 Issued in FL

Practice address

728 N Ferdon Blvd
Ste #3
Crestview, FL 32536-2166

Phone

(850) 682-7772

Fax

(888) 308-1539

NPI assigned

Jun 2, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1275570525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1772",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325367772",
            "telephone_number": "850-682-7772",
            "fax_number": "850-682-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N FERDON BLVD",
            "address_2": "STE #3",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362166",
            "telephone_number": "850-682-7772",
            "fax_number": "888-308-1539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760B Baldwin Ave",
            "address_purpose": "LOCATION",
            "city": "Defuniak Springs",
            "state": "FL",
            "postal_code": "324352598",
            "country_code": "US",
            "telephone_number": "850-892-7772",
            "fax_number": "888-308-1539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410160000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y04XX",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA",
            "identifier": "Y8094",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James L Willis DO PA
• Kenyatta James
• Melanie R James, BCBA
• Theron Quentin Jameson, DO
• Jason G Seymour DMD & Kathleen Haley-Seymour DMD, PA
• Tanya Tamika Jenkins, FNP
• Jennifer H Wayer DMD PA
• Darlene Ivonne Jester
• Tana H Jeter, M.A, CCC-SLP
• John D. Carlson MD

• Physical Therapist in Crestview, FL
• Providers in Crestview, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.