Individual provider Active NPI

Emerald Jenkins

  • Adult Health Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1609659952
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R229747 Issued in MD
Practice address
5310 Old Court Rd Ste 303-304
Randallstown, MD 21133-5243
Phone
(410) 521-8000
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R229747 MD Primary

Addresses

Primary practice location

5310 Old Court Rd Ste 303-304
Randallstown, MD 21133-5243

Mailing address

525 N Wolfe St
Baltimore, MD 21205-2110

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231113000129 MD Practitioner - Nurse Practitioner 7618324732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R229747MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temah Healthcare Services, LLC CurrentSince Nov 2, 2023 Accepting new patients
Hollis Seunarine Mdpa LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

50 Scott Adam Rd
Ste 204
Cockeysville, MD 21030
Phone (410) 521-8000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1609659952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD STE 303-304",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335243",
            "telephone_number": "410-521-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "EMERALD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R229747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.