NPIMap

Organization Active NPI

Jerry H. Jenkins, M.D., P.a.

  • Family Medicine Physician
  • Lufkin, TX
National Provider Identifier
1407946205
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J8603 Issued in TX
Legal business name
JERRY H. JENKINS, M.D., P.A.
Practice address
1105 W Frank Ave
Suite 290
Lufkin, TX 75904-3303
Phone
(936) 699-5040
Fax
(936) 699-5039
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Authorized official

Name
Dr. Jerry H. Jenkins, M.D.NPI 1497783823
Title
President
Phone
(936) 699-5040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X J8603 TX Primary

Addresses

Primary practice location

1105 W Frank Ave
Suite 290
Lufkin, TX 75904-3303

Mailing address

1105 W Frank Ave
Suite 290
Lufkin, TX 75904-3303
Phone (936) 699-5040

Other identifiers 1

IdentifierTypeStateIssuer
124479006MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1407946205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W FRANK AVE",
            "address_2": "SUITE 290",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043303",
            "telephone_number": "936-699-5040",
            "fax_number": "936-699-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W FRANK AVE",
            "address_2": "SUITE 290",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043303",
            "telephone_number": "936-699-5040",
            "fax_number": "936-699-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY H. JENKINS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-699-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124479006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.