Individual provider Active NPI

Deidree Nichole Jenkins, FNP

  • Family Nurse Practitioner
  • Douglas, GA
National Provider Identifier
1730816331
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
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
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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 NCO-000003 GA
Family Nurse Practitioner 363LF0000X RN276896 GA Primary

Addresses

Primary practice location

904 Evergreen LN
Douglas, GA 31533-1801

Mailing address

PO Box 104
Douglas, GA 31534-0104
Phone (678) 584-3999

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL DEIDREEJENKINS@YAHOO.COM Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230126002038 GA Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 4 organizations
I20230621001073 MI Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 3 organizations
I20230718001076 TN Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 2 organizations
I20250210001122 VA Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 2 organizations
I20250512000406 TX Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 1 organization
I20260226004215 DC Practitioner - Nurse Practitioner 1850762063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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)

2541 Milledgeville Rd
Augusta, GA 30904-4954
Phone (737) 226-6700

3355 Lenox Rd NE
Suite 750
Atlanta, GA 30326-1353
Phone (337) 991-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NCO-000003GAMDFamily Nurse Practitioner
RN276896GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health Medical Group LLC CurrentSince Feb 27, 2023 Accepting new patients
Post Acute Specialists, LLC CurrentSince Jan 21, 2026 Accepting new patients
Theoria Medical CurrentSince Jan 2, 2023 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince Jun 10, 2025 Accepting new patients
Mi Post Acute Specialists PC Family CurrentSince Jan 21, 2026 Accepting new patients

Locations

3355 Lenox Rd NE
Ste 750
Atlanta, GA 30326
Phone (470) 682-3536

2541 Milledgeville Rd
Augusta, GA 30904
Phone (706) 735-2581

2274 Salem Rd SE
Ste 1061557
Conyers, GA 30013

2274 Salem Rd SE
Ste 106
Conyers, GA 30013
Phone (404) 631-7716

7300 Lester Rd
Union City, GA 30291
Phone (770) 703-2604

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

1235 Potomac Valley Rd
Rockville, MD 20850
Phone (301) 299-2273

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

2280 Tower Hill Rd
Houghton Lake, MI 48629
Phone (989) 422-5153

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

951 Hickory Creek Dr
Temperance, MI 48182
Phone (734) 206-8200

55378 Wilbur Rd
Three Rivers, MI 49093
Phone (269) 279-7441

1 Veterans Way
Knoxville, TN 37931
Phone (855) 240-2530

141 N McLean Blvd
Memphis, TN 38104
Phone (901) 276-2020

3737 N Garland Ave
Garland, TX 75040
Phone (214) 315-6310

2712 Hurstview Dr
Hurst, TX 76054
Phone (817) 281-6407

9825 S Jordan Gtwy
Sandy, UT 84070

249 S Newtown Rd
Norfolk, VA 23502
Phone (757) 427-4700

1948 Landstown Centre Way
Virginia Beach, VA 23456
Phone (751) 821-7500

Interoperability endpoints

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

Organizations & group practices 7

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": "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": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.