Active NPI
Jordan Jenkins, LAT, ATC
- Athletic Trainer
- Fayette, MO
National Provider Identifier
1568051035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2020026480
- Practice address
- 411 Central Methodist SQ Ste 1
Fayette, MO 65248-1198 - Phone
- (660) 248-6978
- NPI assigned
- Jan 11, 2021
- Last updated
- Jan 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2020026480 | MO | Primary |
Addresses
Primary practice location
411 Central Methodist SQ Ste 1
Fayette, MO 65248-1198
Mailing address
106 S Mulberry St
Fayette, MO 65248-1316
Phone (816) 824-7136
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020026480 | Other | MO | ATHLETIC TRAINER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jcjenkins@centralmethodist.edu | Direct | Central Methodist University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020026480 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1568051035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 S MULBERRY ST",
"city": "FAYETTE",
"state": "MO",
"postal_code": "652481316",
"telephone_number": "816-824-7136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 CENTRAL METHODIST SQ STE 1",
"city": "FAYETTE",
"state": "MO",
"postal_code": "652481198",
"telephone_number": "660-248-6978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JORDAN",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-11",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2020026480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "2020026480",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jcjenkins@centralmethodist.edu",
"affiliation": "Y",
"endpointDescription": "work email",
"affiliationName": "Central Methodist University",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "computer",
"address_1": "411 Central Methodist Sq Ste 1",
"city": "Fayette",
"state": "MO",
"country_code": "US",
"postal_code": "652481198",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fayette, MO
- Howard County Commission (Howard County Public Health Department)
- Howard County Home Health and Hospice (Hometown Homecare)
- Howard County Home Health and Hospice (Hometown Homecare)
- Howard County Home Health and Hospice (Hometown Homecare)
- Howard County Sheltered Services Board
- John Fitzgibbon Memorial Hospital Inc (Fitzgibbon Family Health)
- Just What the Doctor Ordered
- Jacob Ryan Kent
- Teresa Maxine Kircher, CSCS, ATC
- Christina Corinne Kirkendoll, MSN, APRN, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.