Individual provider Active NPI

Leslie C. Jenkins, ARRT, RPA

  • Radiology Practitioner Assistant
  • Effingham, IL
National Provider Identifier
1639206576
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
Practice address
503 N Maple St
Ste 300
Effingham, IL 62401-2006
Phone
(217) 340-1340
NPI assigned
Feb 27, 2007
Last updated
May 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X Primary

Addresses

Primary practice location

503 N Maple St
Ste 300
Effingham, IL 62401-2006

Mailing address

15831 N 1400TH St
Effingham, IL 62401-5210
Phone (720) 427-3016

Other identifiers 1

IdentifierTypeStateIssuer
04004826MedicaidCO

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1639206576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15831 N 1400TH ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624015210",
            "telephone_number": "720-427-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N MAPLE ST",
            "address_2": "STE 300",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012006",
            "telephone_number": "217-340-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LESLIE",
        "middle_name": "C.",
        "credential": "ARRT, RPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04004826",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.