Individual provider Active NPI

Donna F. Jenkins, PH.D.

  • Psychologist
  • Wakefield, MA
National Provider Identifier
1689780702
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6047 Issued in MA
Practice address
599 North Ave
Door 8
Wakefield, MA 01880-1648
Phone
(781) 224-9884
Fax
(781) 224-9632
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6047 MA Primary

Addresses

Primary practice location

599 North Ave
Door 8
Wakefield, MA 01880-1648

Mailing address

9 Pheasant LN
Groveland, MA 01834-2030
Phone (978) 374-1351

Other identifiers 1

IdentifierTypeStateIssuer
0522279MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000048 MA Practitioner - Clinical Psychologist 9234106485 Practice locations: Wakefield, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

591 N Ave
Wakefield, MA 01880-1647
Phone (781) 224-9884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6047MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689780702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PHEASANT LN",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018342030",
            "telephone_number": "978-374-1351",
            "fax_number": "781-224-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 NORTH AVE",
            "address_2": "DOOR 8",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801648",
            "telephone_number": "781-224-9884",
            "fax_number": "781-224-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DONNA",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522279",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

Verify at the official NPI Registry.