Jenna Fenwck

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

451026 Issued in MD

Practice address

15480 Annapolis Rd
Bowie, MD 20715-1852

Phone

(240) 893-9728

NPI assigned

Nov 3, 2019

Last updated

Nov 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572739200000",
    "number": "1770127730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13204 VANESSA AVE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204748",
            "telephone_number": "240-893-9728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15480 ANNAPOLIS RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151852",
            "telephone_number": "240-893-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENWCK",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-03",
        "last_updated": "2019-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MD",
            "license": "451026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROSTHETIC SPECIALIST",
            "identifier": "451026",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "location",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "15480 Annapolis Rd",
            "city": "Bowie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207151852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tayla Fawumi
• Oluwatoyin Titilayo Fayese
• Wanda Featherson
• Jesutomisin T Fekoya
• Devin Ty'Re Felder
• Nina Lomedico Fergus, PHARM.D, RPH
• Marta Gabriela Ferman Fuentes
• Jennifer Aracely Ferman
• Mary Jane Fernandez, PT
• Marneeco Loette Ferrell, CRNP

• Prosthetics Case Management in Bowie, MD
• Providers in Bowie, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.