Tanya Tamika Jenkins, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11001999 Issued in FL

Practice address

210 S Main St
Crestview, FL 32536-3737

Phone

(850) 226-6801

Fax

(877) 413-5104

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamic Pain and Wellness LLCGroup PAC ID 8527364058, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tanya.jenkins@2498.securemail.prognocis.com

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.

• Dynamic Pain & Wellness LLC

  • Anesthesiology Physician
  • Fort Walton Beach, FL
  • NPI 1285007989
  Medicare reassignment Care Compare group NPD
• Dynamic Pain & Wellness LLC

  • Pain Medicine (Anesthesiology) Physician
  • Dothan, AL
  • NPI 1588288641
  NPD

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1548726136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363737",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "TANYA",
        "middle_name": "TAMIKA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-103793",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenyatta James
• Melanie R James, BCBA
• Theron Quentin Jameson, DO
• Jason G Seymour DMD & Kathleen Haley-Seymour DMD, PA
• Ruth Jenkins
• Jennifer H Wayer DMD PA
• Darlene Ivonne Jester
• Tana H Jeter, M.A, CCC-SLP
• John D. Carlson MD
• Jessica L Johnson Simmons

• Family Nurse Practitioner in Crestview, FL
• Providers in Crestview, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.