Active NPI
Jeffrey M Jenkusky, PT, RN
- Physical Therapist
- Spartanburg, SC
National Provider Identifier
1457651499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012768-1
- Practice address
- 100 Summit Hills Dr
Spartanburg, SC 29307-1532 - Phone
- (864) 354-7132
- NPI assigned
- Oct 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8786 | SC | |
| Physical Therapist | 225100000X | 012768-1 | NY | Primary |
Addresses
Primary practice location
100 Summit Hills Dr
Spartanburg, SC 29307-1532
Mailing address
750 E Adams St
Syracuse, NY 13210-2342
Phone (315) 464-2300
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8786 | SC | MD | Physical Therapist |
| 012768-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515110400000",
"number": "1457651499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 E ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132102342",
"telephone_number": "315-464-2300",
"fax_number": "315-464-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SUMMIT HILLS DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293071532",
"telephone_number": "864-354-7132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKUSKY",
"first_name": "JEFFREY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PT, RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-25",
"last_updated": "2018-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "8786",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012768-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.