Active NPI
Lynn C Jenkins, DO
- Family Medicine Physician
- Waukesha, WI
National Provider Identifier
1922059765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LT1120
- Practice address
- W231N1440 Corporate CT
Waukesha, WI 53186-1303 - Phone
- (262) 896-6000
- NPI assigned
- May 15, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LT1120 | WI | Primary |
Addresses
Primary practice location
W231N1440 Corporate CT
Waukesha, WI 53186-1303
Mailing address
W231N1440 Corporate CT
Waukesha, WI 53186-1303
Phone (262) 896-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31463900 | Medicaid | WI | |
| 022000121J | Other | HUMANA |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LT1120 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Union Grove, WI
- NPI 1245440601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354492800000",
"number": "1922059765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W231N1440 CORPORATE CT",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861303",
"telephone_number": "262-896-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W231N1440 CORPORATE CT",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861303",
"telephone_number": "262-896-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "LYNN",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2012-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "LT1120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31463900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "022000121J",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.