Individual provider Active NPI

Marvin Jenkins

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1669317418
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11046551 Issued in FL
Practice address
9438 Maidstone Mill Dr E
Jacksonville, FL 32244-8453
Phone
(904) 383-5753
NPI assigned
Apr 20, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11046551 FL Primary

Addresses

Primary practice location

9438 Maidstone Mill Dr E
Jacksonville, FL 32244-8453

Mailing address

9438 Maidstone Mill Dr E
Jacksonville, FL 32244-8453

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260521002223 FL Practitioner - Nurse Practitioner 3577033364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 Edmondson St
Summerville, GA 30747-2141

PO Box
Kansas City, MO 64180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11046551FLMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1669317418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9438 MAIDSTONE MILL DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322448453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9438 MAIDSTONE MILL DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322448453",
            "telephone_number": "904-383-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11046551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.