Individual provider Active NPI

Matthew D Jenkins, MD

  • Internal Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1467444133
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19650 Issued in SC
Practice address
311 Glenwood Dr
Rock Hill, SC 29732-1818
Phone
(803) 366-7175
Fax
(803) 366-0529
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19650 SC Primary

Addresses

Primary practice location

311 Glenwood Dr
Rock Hill, SC 29732-1818

Mailing address

311 Glenwood Dr
Rock Hill, SC 29732-1818
Phone (803) 366-7175

Other identifiers 1

IdentifierTypeStateIssuer
196503MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000673 SC Practitioner - Internal Medicine 5395929822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

200 Herlong Ave S
Rock Hill, SC 29732-1182

311 Glenwood Dr
Rock Hill, SC 29732-1818
Phone (803) 366-7175

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as individual
Quality
90.99
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19650SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Internal Medicine CurrentSince Oct 2, 2023 Accepting new patients
Carolina Medical Consultants PA Internal Medicine CurrentSince Jul 15, 1997 Accepting new patients
Carolina Community Care Inc PastSince Jul 5, 2021 Accepting new patients

Locations

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

311 Glenwood Dr
Rock Hill, SC 29732
Phone (803) 366-7175

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22888/brand/1/csg/1/fhir/r4

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 3

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1467444133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 GLENWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321818",
            "telephone_number": "803-366-7175",
            "fax_number": "803-366-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 GLENWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321818",
            "telephone_number": "803-366-7175",
            "fax_number": "803-366-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "19650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196503",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.