Individual provider Active NPI

Cynthia Ann Jenkins, CRC, NCLPC

  • Case Manager/Care Coordinator
  • Wilmington, NC
National Provider Identifier
1790993772
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
2068 Issued in NC
Practice address
4114 Breezewood Dr
Unit # 101
Wilmington, NC 28412-5225
Phone
(910) 798-0116
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 2068 NC Primary

Addresses

Primary practice location

4114 Breezewood Dr
Unit # 101
Wilmington, NC 28412-5225

Mailing address

4114 Breezewoood Drive
Apt. #101
Wilmington, NC 28412-8517
Phone (910) 798-0116

Other identifiers 2

IdentifierTypeStateIssuer
2068OtherNCLIC PRACT COUNSELOR
00009616OtherNAT'L CERT REHAB COUNSEL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2068NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1790993772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 BREEZEWOOOD DRIVE",
            "address_2": "APT. #101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284128517",
            "telephone_number": "910-798-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 BREEZEWOOD DR",
            "address_2": "UNIT # 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284125225",
            "telephone_number": "910-798-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CRC,  NCLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "2068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC PRACT COUNSELOR",
            "identifier": "2068",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAT'L CERT REHAB COUNSEL",
            "identifier": "00009616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.