Active NPI
Robert Fredrick Jenkins, RN
- Registered Nurse
- Boulder, CO
National Provider Identifier
1831706753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1617324
- Practice address
- 3482 Broadway St
Boulder, CO 80304-1824 - Phone
- (720) 217-7937
- NPI assigned
- Sep 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1617324 | CO | Primary |
Addresses
Primary practice location
3482 Broadway St
Boulder, CO 80304-1824
Mailing address
3450 Broadway St
Boulder, CO 80304-1824
Phone (720) 217-7937
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rjenkins@bouldercounty.org | Direct |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1617324 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1831706753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041824",
"telephone_number": "720-217-7937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3482 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041824",
"telephone_number": "720-217-7937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "ROBERT",
"middle_name": "FREDRICK",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-24",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "1617324",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rjenkins@bouldercounty.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3482 Broadway St",
"city": "Boulder",
"state": "CO",
"country_code": "US",
"postal_code": "803041824",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.