NPIMap

Individual provider Active NPI

Mark D Jenkins, MD

  • Orthopaedic Trauma Physician
  • Lubbock, TX
National Provider Identifier
1831132430
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
M6212 Issued in TX
Practice address
3506 21St St Ste 507
Lubbock, TX 79410-1233
Phone
(806) 725-4860
Fax
(806) 723-7815
NPI assigned
Jun 13, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M6212 TX
Orthopaedic Trauma Physician 207XX0801X M6212 TX Primary

Addresses

Primary practice location

3506 21St St Ste 507
Lubbock, TX 79410-1233

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other practice location 1

3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-2475

Other identifiers 1

IdentifierTypeStateIssuer
187029701MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.jenkins@direct.myteamcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000231 TX Practitioner - Orthopedic Surgery 3476566498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

3506 21St St
Suite 507
Lubbock, TX 79410-1233
Phone (806) 725-1920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue18
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6212TXMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Aug 1, 2007 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Orthopaedic Surgery CurrentSince Aug 1, 2007 Accepting new patients
Covenant Medical Group Orthopaedic Surgery CurrentSince Jul 1, 2022 Accepting new patients
Covenant Medical Group CurrentSince Jul 1, 2022 Accepting new patients

Locations

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3506 21st St
Ste 507
Lubbock, TX 79410
Phone (806) 725-4805

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
#1B350K
Lubbock, TX 79430
Phone (806) 743-2981

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Interoperability endpoints

  • Direct secure messaging: mark.jenkins@direct.myteamcare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1831132430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 21ST ST STE 507",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101233",
            "telephone_number": "806-725-4860",
            "fax_number": "806-723-7815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-2475",
            "fax_number": "806-743-1394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "M6212",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TX",
            "license": "M6212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187029701",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.jenkins@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.