Individual provider Active NPI

Samuel Jenkins, RRT

  • General Acute Care Hospital
  • Charleston, SC
National Provider Identifier
1386076792
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Practice address
109 Bee St
Charleston, SC 29401-5703
Phone
(843) 577-5011
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

109 Bee St
Charleston, SC 29401-5703

Mailing address

1422 Haynes St
Orangeburg, SC 29115-7911
Phone (803) 533-1004

Other identifiers 1

IdentifierTypeStateIssuer
227900000XMedicaidSC

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

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1386076792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 HAYNES ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291157911",
            "telephone_number": "803-533-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227900000X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.