Individual provider Active NPI

Carrie J Jenkins, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Joplin, MO
National Provider Identifier
1689140832
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018035339 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 781-2727
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61539754 WA
Family Nurse Practitioner 363LF0000X 2018035339 MO Primary

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 781-2727

Other practice location 1

1100 Goethals Dr Ste E
Richland, WA 99352-3301
Phone (509) 942-3095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IA, WV3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191106000894 MO Practitioner - Nurse Practitioner 6204168560 Reassigns benefits to 1 organization
I20211019003123 IA Practitioner - Nurse Practitioner 6204168560 Reassigns benefits to 1 organization
I20241018002678 WV Practitioner - Nurse Practitioner 6204168560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018035339MOMDFamily Nurse Practitioner
AP61539754WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Oct 1, 2021 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 22, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 22, 2024 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

400 E Court Ave
Ste 110
Des Moines, IA 50309

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 310
Joplin, MO 64804

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

705 Garfield Ave
Ste 460
Parkersburg, WV 26101
Phone (304) 424-2093

Organizations & group practices 4

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1689140832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Goethals Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523301",
            "country_code": "US",
            "telephone_number": "509-942-3095",
            "fax_number": "509-942-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CARRIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61539754",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018035339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.