Active NPI
John D Jenkins, D.C.
- Chiropractor
- Menasha, WI
National Provider Identifier
1669467700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1820-012
- Practice address
- 1981 Midway Rd
Suite a
Menasha, WI 54952-7001 - Phone
- (920) 830-8700
- NPI assigned
- Sep 14, 2005
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1820-012 | WI | Primary |
Addresses
Primary practice location
1981 Midway Rd
Suite a
Menasha, WI 54952-7001
Mailing address
1981 Midway Rd
Suite a
Menasha, WI 54952-7001
Phone (920) 830-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38781400 | Medicaid | WI |
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 |
|---|---|---|---|
| 1820-012 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305676800000",
"number": "1669467700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1981 MIDWAY RD",
"address_2": "SUITE A",
"city": "MENASHA",
"state": "WI",
"postal_code": "549527001",
"telephone_number": "920-830-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1981 MIDWAY RD",
"address_2": "SUITE A",
"city": "MENASHA",
"state": "WI",
"postal_code": "549527001",
"telephone_number": "920-830-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JOHN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2011-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "1820-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38781400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.