Timothy K Jennings, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2478 Issued in KY

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-4677

NPI assigned

Aug 21, 2006

Sex

Male

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 IL, KY2 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 2

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Merit-based Incentive Payment System (MIPS)

Final score

62.45 of 100Reported as group

Quality

50.17

Promoting interoperability

100

Improvement activities

0

Cost

74.66

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjennings84589@sih.direct-ci.com
• Direct secure messaging: tjennings14011@sih.direct-ci.com

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.

• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093

  IL, Physician Assistant

  Medicare reassignment NPD
• Orthopaedic Institute of Western Kentucky PLLC

  • Orthopaedic Surgery Physician
  • Paducah, KY
  • NPI 1497425177

  IL

  Medicare reassignment
• Mercy Health Physicians Kentucky LLC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922243690

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1750496378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1390 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629015306",
            "country_code": "US",
            "telephone_number": "618-351-4972",
            "fax_number": "618-351-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "TIMOTHY",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001881",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjennings14011@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1390 Hope Dr",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629015306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine McHugh Jarnagin, RDH
• Donald William Jarvis, LPN
• Keisha Jefferson
• Molly Jenczalik
• Paris Lashawn Jenkins, CSW
• Christian G Jensen, D.O.
• Josef Brent Jessop, MD
• Emma Marie Jessup, PA-C
• Lawonda Jiggetts, LPN
• Alexandria Jimenez

• Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.