Carolyn Jendrek, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0017868 Issued in MD

Practice address

705 Digital Dr Ste G
Linthicum Heights, MD 21090-2267

Phone

(773) 292-4800

Fax

(312) 564-4059

NPI assigned

Jul 13, 2010

Last updated

Aug 15, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: carolyn.jendrek.p1@direct.alegiscare.nextgenshare.com
• Direct secure messaging: carolyn.jendrek.p2@direct.alegiscare.nextgenshare.com
• Direct secure messaging: cjendrek33364@evernorth.direct-ci.com

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1275845638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIGITAL DR STE G",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210902267",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENDREK",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0017868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Linthicum Heights, MD
• Providers in Linthicum Heights, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.