Charles Jenkins III, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN143268NP Issued in GA

Practice address

4390 Governors Drive
Suite 409
Forest Park, GA 30297-6101

Phone

(404) 366-3647

Fax

(404) 366-3648

NPI assigned

Apr 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Emir Primary Care

  • Primary Care Clinic/Center
  • Forest Park, GA
  • NPI 1134414105
  Medicare reassignment NPD Authorized official
• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment NPD
• Emory Medical Care Foundation

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1982860490
  NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• JW Medical Care, LLC

  • Family Medicine Physician
  • College Park, GA
  • NPI 1730329806
  NPD (past)

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1841516630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 GOVERNORS DR",
            "address_2": "SUITE 409",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976101",
            "telephone_number": "404-366-3647",
            "fax_number": "404-366-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 GOVERNORS DRIVE",
            "address_2": "SUITE 409",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976101",
            "telephone_number": "404-366-3647",
            "fax_number": "404-366-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHARLES",
        "name_suffix": "III",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN143268NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paola Hoyo Figueroa, DC
• Niambi Ibim, OTR/L
• Integrated Health and Wellness Solutions
• Ips of Forest Park LLC
• Rose M James, DPM
• Amisa Jiwani, APRN
• Xavier Johnson, NCTMB, CMT, CMMT
• Michael Reu Johnston, D.C.
• Nadrieka Jones, APRN
• Vaughnette M Jones, MD

• Family Nurse Practitioner in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.