Individual provider Active NPI

Jerry H Jenkins, M.D.

  • Emergency Medicine Physician
  • Lufkin, TX
National Provider Identifier
1497783823
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J8603 Issued in TX
Practice address
2427 FM 3258
Lufkin, TX 75904-0683
Phone
(936) 676-1030
Fax
(936) 875-5197
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J8603 TX
Emergency Medicine Physician 207P00000X J8603 TX Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X J8603 TX

Addresses

Primary practice location

2427 FM 3258
Lufkin, TX 75904-0683

Mailing address

2427 FM 3258
Lufkin, TX 75904-0683
Phone (936) 676-1030

Other identifiers 1

IdentifierTypeStateIssuer
172791901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041022001044 TX Practitioner - Emergency MedicinePractitioner - Family Practice 4082675012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

2901 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

Hospital & facility affiliations

  • Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
Ess of Nacogdoches LLC Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Mar 21, 2016 Accepting new patients
Dr Royce Read, MD and Associates Family Medicine Past Accepting new patients
Family Practice Associates of Hamilton Co PA Family Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients
Jerry H. Jenkins, M.D., P.a. Family Medicine PastSince May 17, 2004 Accepting new patients
Republic of Texas Inpatient Services PLLC Past Accepting new patients

Locations

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

Organizations & group practices 8

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 2

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1497783823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 FM 3258",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759040683",
            "telephone_number": "936-676-1030",
            "fax_number": "936-875-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 FM 3258",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759040683",
            "telephone_number": "936-676-1030",
            "fax_number": "936-875-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JERRY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8603",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J8603",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "J8603",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172791901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.