Active NPI
Jason R Jenkins, D.C.
- Orthopedic Chiropractor
- Milford, CT
National Provider Identifier
1619034733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 1371
- Practice address
- 97 Gulf St
Milford, CT 06460-4812 - Phone
- (203) 877-4198
- Fax
- (203) 877-6394
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 1371 | CT | Primary |
Addresses
Primary practice location
97 Gulf St
Milford, CT 06460-4812
Mailing address
97 Gulf St
Milford, CT 06460-4812
Phone (203) 877-4198
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3191251 | Other | CT | AETNA PROVIDER NUMBER |
| 1998049 | Other | CT | UNITED HEALTH PROVIDER NO |
| 050001371CT02 | Other | CT | ANTHEM PROVIDER NUMBER |
| P2188667 | Other | CT | OXFORD PROVIDER NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1371 | CT | MD | Orthopedic Chiropractor |
| 001371 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619034733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 GULF ST",
"city": "MILFORD",
"state": "CT",
"postal_code": "064604812",
"telephone_number": "203-877-4198",
"fax_number": "203-877-6394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 GULF ST",
"city": "MILFORD",
"state": "CT",
"postal_code": "064604812",
"telephone_number": "203-877-4198",
"fax_number": "203-877-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JASON",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "CT",
"license": "1371",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "3191251",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH PROVIDER NO",
"identifier": "1998049",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "050001371CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD PROVIDER NUMBER",
"identifier": "P2188667",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.