Active NPI
Andrea Chanel Jenkins, MPC
- Prosthetics Case Management
- Grovetown, GA
National Provider Identifier
1821826066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- Practice address
- 523 Ernestine Falls
Grovetown, GA 30813-5517 - Phone
- (843) 801-5558
- NPI assigned
- Jul 22, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | Primary |
Addresses
Primary practice location
523 Ernestine Falls
Grovetown, GA 30813-5517
Mailing address
523 Ernestine Falls
Grovetown, GA 30813-5517
Phone (843) 801-5558
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1821826066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 ERNESTINE FALLS",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308135517",
"telephone_number": "843-801-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 ERNESTINE FALLS",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308135517",
"telephone_number": "843-801-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "ANDREA",
"middle_name": "CHANEL",
"credential": "MPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grovetown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.