Deidree Nichole Jenkins, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN276896 Issued in GA

Practice address

904 Evergreen LN
Douglas, GA 31533-1801

Phone

(678) 584-3999

NPI assigned

Aug 3, 2022

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, MI, TN, VA, TX, DC6 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 6

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Curana Health Medical Group LLCGroup PAC ID 9133304603, 132 clinicians

CH Specialty Services Ga LLCGroup PAC ID 8921464579, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Curana Health Medical Group LLC

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1255640678

  GA

  Medicare reassignment Care Compare group NPD
• CH Specialty Services Ga LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1306545181
  Medicare reassignment Care Compare group
• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933
  Medicare reassignment NPD
• Mi Post Acute Specialists PC

  • Internal Medicine Physician
  • Lansing, MI
  • NPI 1013425479

  Family

  Medicare reassignment NPD
• Post Acute Specialists, LLC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1114441565

  DC, TN, VA

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA, TN, TX, VA

  Medicare reassignment NPD
• Curana Health of Georgia LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1043605314
  Medicare reassignment
• Wellbridge of Clarkston, LLC

  • Skilled Nursing Facility
  • Independence Township, MI
  • NPI 1669965299
  NPD (past)

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1730816331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315340104",
            "telephone_number": "678-584-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 EVERGREEN LN",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331801",
            "telephone_number": "678-584-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DEIDREE",
        "middle_name": "NICHOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NCO-000003",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN276896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DEIDREEJENKINS@YAHOO.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "904 Evergreen Ln",
            "city": "Douglas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315331801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2373)
• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2306)
• J M Bailey Pharmacy Inc (Fulco Discount Drugs)
• Patricia Arasely Jaimes
• Kirstyn Mahalia James, DC
• JLD Speech Therapy, LLC
• JM Bailey Pharm (Fulco Discount Drug)
• John B Moffet DC PC
• Lajuanna Johnson
• Marci McQuaig Johnson, FNP-C

• Family Nurse Practitioner in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.