Organization Active NPI

Jessica Marie Adkins MD PC

  • Internal Medicine Physician
  • Thousand Oaks, CA
National Provider Identifier
1487269072
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JESSICA MARIE ADKINS MD PC
Practice address
415 Rolling Oaks Drive
Suite 260
Thousand Oaks, CA 91361-1033
Phone
(805) 908-8100
NPI assigned
Sep 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Dr. Jessica Marie Adkins, MDNPI 1194968362
Title
Owner/President
Phone
(805) 908-8100

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

415 Rolling Oaks Drive
Suite 260
Thousand Oaks, CA 91361-1033

Mailing address

415 Rolling Oaks Drive Suite 260
Thousand Oaks, CA 91361-1033
Phone (805) 908-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200924001129 CA Part B Supplier - Clinic/Group Practice 9133548134 Receives reassigned benefits from 1 practitioner
Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

77 Rolling Oaks Dr
Ste 305
Thousand Oaks, CA 91361
Phone (805) 379-9976

558 Saint Charles Dr
Ste 11
Thousand Oaks, CA 91360

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": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1487269072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DRIVE SUITE 260",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611033",
            "telephone_number": "805-908-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DRIVE",
            "address_2": "SUITE 260",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611033",
            "telephone_number": "805-908-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA MARIE ADKINS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "805-908-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.