Brian Scott Jenks, D.O.
Individual provider Active NPI Family Medicine Physician · Jamestown, OH
NPI 1669737250 · NPPES record last updated Jan 20, 2021
Key facts
- NPI
- 1669737250
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34.011084 (OH)
- Practice address
- 4940 Cottonville Rd
Suite 100
Jamestown, OH 45335-1522 - Phone
- (937) 675-6830
- NPI assigned
- Jul 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150728004866 | OH | Practitioner - Family Practice | 9931413424 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.011084 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mvhe Inc | Current |
Accepting new patients | |
| Mvhe Inc | Family Medicine | Current |
Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000
2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831
4940 Cottonville Rd
Ste 100
Jamestown, OH 45335
Phone (937) 675-6830
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34.011084 | OH | Yes |
Addresses
Primary practice location
4940 Cottonville Rd
Suite 100
Jamestown, OH 45335-1522
Mailing address
4790 Cottonville Rd
Jamestown, OH 45335-1518
Phone (937) 675-2870
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | bjenks571509@direct.ketteringhealth.org |
Other providers in Jamestown, OH
- James Halderman
- Erica Lynn Haller
- Christina Lynn Harlow
- Joyce Elaine-Blackmer Hull
- IHS Pharmacy & Wellness Center
- Susan K Jordan
- Denise R Kennedy
- Liberty Nursing Center of Jamestown
- Darrell Clark McQuary
- Angelia M Mickle
All providers in Jamestown, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.