Jerry Jenkins II DPM

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

221 Issued in AL

Legal business name

JERRY JENKINS II DPM

Doing business as

RUSSELLVILLE PODIATRY CENTER

Practice address

533 Gandy St NE
Russellville, AL 35653-1965

Phone

(256) 331-3338

Fax

(256) 331-2890

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Jenkins II, D.P.M.

Title

Sole Proprietor

Phone

(256) 331-3338

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RUSSELLVILLE PODIATRY CENTER Doing business as

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1801069752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5268",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155200",
            "telephone_number": "256-331-3338",
            "fax_number": "256-331-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531965",
            "telephone_number": "256-331-3338",
            "fax_number": "256-331-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY JENKINS II DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "256-331-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DPM221",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RUSSELLVILLE PODIATRY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bettie S Hillman, EDD, LPC
• Darlina F Holcomb, CRNP
• John Albert Indovina Jr., M.D.
• Domenica Raegene Nycole Jackson
• Jerry Jenkins II, DPM
• JMJ Anesthesia PC
• John R Almirol M.D.
• Elizabeth Vonscelle Johnson, FNP-C
• Katherine Marie Johnson, LPTA
• Daphne Lynn Jones, MD

• Durable Medical Equipment & Medical Supplies in Russellville, AL
• Providers in Russellville, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.