Jendayi Renea Watkins

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2065 Half Day Rd
Deerfield, IL 60015-1241

Phone

(630) 487-9241

NPI assigned

Sep 13, 2017

Last updated

Sep 3, 2026By 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 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1306365150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 LABONTE PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 HALF DAY RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600151241",
            "telephone_number": "630-487-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JENDAYI",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "APRN-NP300203",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "APRN-NP300203",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "XOH846989710",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell L Warren, M.D.
• Jordan Washburn, BCBA
• Dajanae Washington
• Maciej Wasilewicz
• Abby Watel, LCSW
• Bonnie Eva Weber, PHARMD
• Mary R. Weeden, RN, LCSW
• Isabell Weintraub, LCSW
• Tyler Wendt
• Whitehall North, L.L.C. (Whitehall of Deerfield)

• Athletic Trainer in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.