Tyler Huntington-Reade Jenkins, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102203114 Issued in VA

Practice address

3344 Pineland Rd SW
Roanoke, VA 24018-2152

Phone

(910) 551-9429

NPI assigned

Jun 18, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, NC, IL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bladen Healthcare LLCGroup PAC ID 6800967969, 41 clinicians

Trinity Medical Staffing LLCGroup PAC ID 1759712698, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of Southern Illinois, Inc Hospice, Belleville, IL, CCN 141504
• Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184
• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjenkins113403@capefearvalley.direct-ci.com
• Direct secure messaging: tjenkins71126@sih.direct-ci.com
• Direct secure messaging: tjenkins409848@direct.ecuhealth.com

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.

• Bladen Healthcare LLC

  dba Cape Fear Valley Bladen County Hospital

  • Critical Access Hospital
  • Elizabethtown, NC
  • NPI 1558537282
  Medicare reassignment Care Compare group NPD
• Trinity Medical Staffing LLC

  • Internal Medicine Physician
  • Harrisburg, IL
  • NPI 1770103426
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Virginia LLC

  • Internal Medicine Physician
  • Winchester, VA
  • NPI 1770756991

  Family Medicine

  Medicare reassignment NPD
• Lake Spring Physician Services, LLC

  • Hospitalist Physician
  • Salem, VA
  • NPI 1568954287
  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Virginia

  dba MedExpress Urgent Care - Bluefield

  • Urgent Care Clinic/Center
  • Bluefield, VA
  • NPI 1215219878

  Family Medicine

  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD
• Cumberland County Hospital System Inc

  dba Oncology Services

  • Hematology & Oncology Physician
  • Fayetteville, NC
  • NPI 1881946242
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Watauga Medical Center, Inc.

  dba Watauga Medical Center

  • Hospitalist Physician
  • Boone, NC
  • NPI 1528134194
  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Richmond, VA
  • NPI 1225563679

  Family Medicine

  NPD
• Bladen Healthcare LLC

  dba CFV Primary Care-Vineland Family Medicine

  • Rural Health Clinic/Center
  • Whiteville, NC
  • NPI 1821764390
  NPD
• Bladen Healthcare, LLC

  dba Cape Fear Valley BMA Hospitalists

  • Hospitalist Physician
  • Elizabethtown, NC
  • NPI 1689018756
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Hospital Inc

  dba The Women's Hospital

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation
• Deaconess Regional Healthcare Services Illinois Inc

  dba Deaconess Illinois Medical Center

  • General Acute Care Hospital
  • Marion, IL
  • NPI 1750007266
  Care Compare affiliation
• Harrisburg Medical Center Inc

  • General Acute Care Hospital
  • Harrisburg, IL
  • NPI 1073580130
  Care Compare affiliation
• Hospice of Southern Illinois, Inc.

  • Community Based Hospice Care Agency
  • Belleville, IL
  • NPI 1720081805
  Care Compare affiliation
• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1912228404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 PINELAND RD SW # SWW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182152",
            "telephone_number": "910-551-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 PINELAND RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240182152",
            "telephone_number": "910-551-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "TYLER",
        "middle_name": "HUNTINGTON-READE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102203114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Surgical Clinic Inc
• Monique C Jefferson, AGACNP-BC
• William Emmett Jefferson III, MD
• David Lee Jeffries, AGACNP-BC
• Pamela Diane Jenkins, OTA
• Cathy Dickinson Jennings, DNP, RN
• Madolyn Grace Jennings
• Victoria Anna Jennings, PA-C
• Boyd Jensen III, D.P.M.
• Brian David Jensen, D.C.

• Family Medicine Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.