NPIMap

Individual provider Active NPI

Eric J Jenkinson, MD

  • Pediatric Sports Medicine Physician
  • Redding, CA
National Provider Identifier
1427057132
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
01050809A Issued in IN
Practice address
1255 Liberty St
Redding, CA 96001-0814
Phone
(530) 246-2467
Fax
(530) 246-5632
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 01050809A IN Primary

Addresses

Primary practice location

1255 Liberty St
Redding, CA 96001-0814

Mailing address

PO Box 991950
Redding, CA 96099-1950
Phone (530) 246-2457

Other identifiers 2

IdentifierTypeStateIssuer
200216530MedicaidIN
250011958OtherINRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150707002537 CA Practitioner - Sports MedicinePractitioner - Pediatric Medicine 2961696513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Pediatric Medicine
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1255 Liberty St
Redding, CA 96001-0814
Phone (530) 246-2467

Hospital & facility affiliations

  • Interim Healthcare Home health agency, Redding, CA, CCN 557630
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Trinity Hospital Hospital, Weaverville, CA, CCN 051315

Merit-based Incentive Payment System (MIPS)

Final score
96.52 of 100Reported as group
Quality
92.31
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Orthopedics & Sports Medicine a Medical Corporation Sports Medicine CurrentSince May 3, 2015 Accepting new patients
Apogee Outpatient Surgery Center Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1255 Liberty St
Redding, CA 96001
Phone (530) 246-2467

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1427057132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 991950",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960991950",
            "telephone_number": "530-246-2457",
            "fax_number": "530-246-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467",
            "fax_number": "530-246-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINSON",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "IN",
            "license": "01050809A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200216530",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "250011958",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.