Ken Jenks, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 1103 Issued in CO

Practice address

421 W Adams
Naturita, CO 81422

Phone

(970) 865-2665

Fax

(970) 865-2674

NPI assigned

Dec 22, 2006

Last updated

Jun 13, 2013By the provider in NPPES

Sex

Male

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

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ken.jenks.1@17367.direct.athenahealth.com

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.

• Mountain Radiology, Inc

  • Diagnostic Radiology Physician
  • Grand Junction, CO
  • NPI 1093823742
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1306901186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "NATURITA",
            "state": "CO",
            "postal_code": "814220340",
            "telephone_number": "970-865-2665",
            "fax_number": "970-865-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W ADAMS",
            "city": "NATURITA",
            "state": "CO",
            "postal_code": "81422",
            "telephone_number": "970-865-2665",
            "fax_number": "970-865-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "KEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA 1103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basin Clinic Inc
• Sharon Lynn Brodbelt, PA-C
• Elizabeth L Brown, FNP
• Mary A. Kus, APRN, FNP-C
• Eugene Joseph Lucero, PAC
• MLS Senior Care LLC
• Montrose County School District Re-2
• April Lee Randle, M.D.

• Physician Assistant in Naturita, CO
• Providers in Naturita, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.