Jencare Neighborhood Medical Center South Dekalb, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

069385 Issued in GA

Legal business name

JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH DEKALB, LLC

Practice address

2124 Candler Rd
Decatur, GA 30032-5572

Phone

(305) 628-6117

NPI assigned

Mar 11, 2013

Organization subpart

No

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

Authorized official

Name

Mary Chen

Title

Authorized Offical

Phone

(305) 831-4722

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1912248345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH DEKALB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "305-831-4722"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "069385",
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "GA",
            "license": "069385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff a Traub, MD, PC
• Jeffrey K Waters D.M.D., P.C
• Kimberly Jeffrey, M.S. CCC/SLP
• Annemarie Jeffries, PSYD
• Jefrey D Lieberman MD PC
• Charlene Jenkins, LPC
• Dionne L. Jenkins, LCSW
• Jamila Jameace Jenkins
• Karentyn Paige Jenkins
• Miesha Jenkins, M.ED, SLP

• Specialist in Decatur, GA
• Providers in Decatur, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.