Active NPI
Patricia Ann Jenkins, PH.D,
- Psychologist
- Silver Spring, MD
National Provider Identifier
1780966002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01992
- Practice address
- 13617 Jacqueline CT
Silver Spring, MD 20904-5468 - Phone
- (301) 236-0636
- Fax
- (301) 384-9419
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01992 | MD | Primary |
Addresses
Primary practice location
13617 Jacqueline CT
Silver Spring, MD 20904-5468
Mailing address
13617 Jacqueline CT
Silver Spring, MD 20904-5468
Phone (301) 236-0636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Howard University College of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8181 Professional PL
Suite 200
Landover, MD 20785-7219
Phone (301) 306-4590
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01992 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interdynamics, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Landover, MD
- NPI 1770135261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1780966002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13617 JACQUELINE CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209045468",
"telephone_number": "301-236-0636",
"fax_number": "301-384-9419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13617 JACQUELINE CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209045468",
"telephone_number": "301-236-0636",
"fax_number": "301-384-9419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "PATRICIA",
"middle_name": "ANN",
"credential": "PH.D,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "01992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.