Jen Med Prof LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1034 Issued in SD

Legal business name

JEN MED PROF LLC

Practice address

1010 Ballpark Rd
Suite 2
Sturgis, SD 57785-2364

Phone

(605) 347-3684

Fax

(605) 347-0083

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

George W. Jenter, D.O.

Title

Owner/Operator

Phone

(605) 347-3684

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Sturgis Medical Center Former legal business name

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1528020229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 BALLPARK RD",
            "address_2": "SUITE 2",
            "city": "STURGIS",
            "state": "SD",
            "postal_code": "577852364",
            "telephone_number": "605-347-3684",
            "fax_number": "605-347-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BALLPARK RD",
            "address_2": "SUITE 2",
            "city": "STURGIS",
            "state": "SD",
            "postal_code": "577852364",
            "telephone_number": "605-347-3684",
            "fax_number": "605-347-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEN MED PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JENTER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "605-347-3684",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP PROVIDER",
            "identifier": "142389900",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADIATION MEDICAL LICENSE",
            "identifier": "42339",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAA LICENSE NUMBER",
            "identifier": "14172-1",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TITLE 19",
            "identifier": "5602360",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S2312",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S LICENSE",
            "identifier": "1034",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LAB",
            "identifier": "43D0408177",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sturgis Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in Sturgis, SD
• Providers in Sturgis, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.