Individual provider Active NPI

Matthew Jenkins, M.D.

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1306141197
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33784 Issued in SC
Practice address
555 E Cheves St
Florence, SC 29506-2617
Phone
(843) 777-2800
NPI assigned
Jan 25, 2011
Last updated
Jul 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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 33784 SC Primary

Addresses

Primary practice location

555 E Cheves St
Florence, SC 29506-2617

Mailing address

PO Box 100551
Florence, SC 29502-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812001987 GA Practitioner - Family Practice 0749438224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical Center of Elberton, LLPGroup PAC ID 2062493083, 7 clinicians

Practice addresses (Care Compare)

109 College Ave
Elberton, GA 30635-1705
Phone (706) 283-3315

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33784SCMDFamily Medicine Physician

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Medical Center of Elberton LLPElberton, GA, CCN 113958 Rural health clinic 5% Or Greater Direct Ownership Interest (16.66%)
General Partnership Interest (16.66%)
Aug 1, 2016
Aug 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1306141197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100551",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295020551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "843-777-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "33784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.