Individual provider Active NPI

Emily Kate Jenkins, CPNP

  • Pediatric Nurse Practitioner
  • Georgetown, SC
National Provider Identifier
1366905655
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
22798 Issued in SC
Practice address
435 Marina Dr
Georgetown, SC 29440-2410
Phone
(843) 833-8595
NPI assigned
Apr 12, 2019
Last updated
Apr 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 22798 SC Primary

Addresses

Primary practice location

435 Marina Dr
Georgetown, SC 29440-2410

Mailing address

302 Grove St
Charleston, SC 29403-3540
Phone (843) 864-6080

Other practice location 1

402 Nelson Blvd Ste 100
Kingstree, SC 29556-4058
Phone (843) 401-4200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tiemakers@comcast.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22798SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oakbrook Pediatrics, PA Past Accepting new patients
Es Pediatric Partners LLC Past Accepting new patients
Sweetgrass Pediatrics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1366905655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 GROVE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294033540",
            "telephone_number": "843-864-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MARINA DR",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402410",
            "telephone_number": "843-833-8595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 Nelson Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kingstree",
            "state": "SC",
            "postal_code": "295564058",
            "country_code": "US",
            "telephone_number": "843-401-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "EMILY",
        "middle_name": "KATE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "22798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiemakers@comcast.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "435 Marina Dr",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294402410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.