Individual provider Active NPI

John R Jenkins, D.O.

  • Internal Medicine Physician
  • Morehead, KY
National Provider Identifier
1790030013
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04719 Issued in KY
Practice address
222 Medical Cir
Morehead, KY 40351-1179
Phone
(606) 783-6500
Fax
(606) 783-6598
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102203664 VA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 04719 KY Primary

Addresses

Primary practice location

222 Medical Cir
Morehead, KY 40351-1179

Mailing address

222 Medical Cir
Morehead, KY 40351-1179
Phone (606) 783-6500

Other practice location 1

100 15th St NW
Suite 307
Norton, VA 24273-1616
Phone (276) 439-1140

Other identifiers 2

IdentifierTypeStateIssuer
1790030013MedicaidVA
7100667890MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150904000028 VA Practitioner - Internal Medicine 2466768569 Reassigns benefits to 1 organization
I20200702001738 KY Practitioner - Internal Medicine 2466768569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Claire Medical Center IncGroup PAC ID 4486559085, 181 clinicians

Practice addresses (Care Compare)

222 Medical Cir
Morehead, KY 40351-1179
Phone (606) 783-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
04719KYMDInternal Medicine Physician
0102203664VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Aug 1, 2015 Accepting new patients
Blue Ridge Medical Management Corporation Multi-Specialty CurrentSince Aug 1, 2015 Accepting new patients
Blue Ridge Medical Management Corporation Multi-Specialty Current Accepting new patients
St Claire Medical Center, Inc CurrentSince Jul 1, 2020 Accepting new patients
St Claire Medical Center, Inc., Multi-Specialty CurrentSince Jul 1, 2020 Accepting new patients
St Claire Medical Center Inc Multi-Specialty Past Accepting new patients

Locations

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

100 15th St NW
Ste 307
Norton, VA 24273
Phone (276) 439-1450

100 15th St NW
#307
Norton, VA 24273
Phone (276) 439-1140

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1790030013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MEDICAL CIR",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511179",
            "telephone_number": "606-783-6500",
            "fax_number": "606-783-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MEDICAL CIR",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511179",
            "telephone_number": "606-783-6500",
            "fax_number": "606-783-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 15th St NW",
            "address_2": "Suite 307",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731616",
            "country_code": "US",
            "telephone_number": "276-439-1140",
            "fax_number": "276-439-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102203664",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "04719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790030013",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100667890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.