Charles William Jenks

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1246 Yellowstone Ave Ste C5
Pocatello, ID 83201-4373

Phone

(208) 233-0150

Fax

(208) 233-0159

NPI assigned

May 2, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Assessment Specialists PLLCGroup PAC ID 6608815303, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Assessment Specialists

  • Clinical Psychologist
  • Pocatello, ID
  • NPI 1922129840
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1295145985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE STE C5",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014373",
            "telephone_number": "208-233-0150",
            "fax_number": "208-233-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE STE C5",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014373",
            "telephone_number": "208-233-0150",
            "fax_number": "208-233-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Miren Jayo
• Janice Jean, MOTR/L,CHT
• McKenzie Jemmett, SLP
• Jacquie Kathleen Jenkins, COTA/L
• Jeremy John Jenkins, DPT
• Jennifer Miesch PHD
• Eric Jensen, MD
• Jamee Lee Jensen
• Timothy Robert Jessop, DDS
• Kristen Jex, LPC

• Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.