Individual provider Active NPI

Abagael R Jenkins

  • Psychiatric/Mental Health Nurse Practitioner
  • Tipton, IN
National Provider Identifier
1922745579
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71012910A Issued in IN
Practice address
202 S West St Ste B
Tipton, IN 46072-1848
Phone
(765) 408-0570
Fax
(765) 453-8008
NPI assigned
May 16, 2022
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71012910A IN Primary
Registered Nurse 163W00000X 28232523A IN

Addresses

Primary practice location

202 S West St Ste B
Tipton, IN 46072-1848

Mailing address

202 S West St
Tipton, IN 46072-1848
Phone (765) 408-0570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20220818002792 IN Practitioner - Nurse Practitioner 5294118568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

202 S W St B
Tipton, IN 46072-1848
Phone (765) 408-0570

7165 Clearvista Way
Gallahue Mental Health Services
Indianapolis, IN 46256-4621
Phone (317) 621-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.35 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
81.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71012910AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc CurrentSince Oct 1, 2024 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Howard Regional Health Inc CurrentSince Oct 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

205 N Jackson St
Frankfort, IN 46041
Phone (765) 659-4771

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

7165 Clearvista Way
Indianapolis, IN 46256
Phone (317) 621-5100

202 S West St
Tipton, IN 46072
Phone (765) 408-0570

202 S West St
#B
Tipton, IN 46072
Phone (765) 408-0570

Interoperability endpoints

  • Direct secure messaging: ajenkins628691@ecommunitydirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1922745579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S WEST ST",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460721848",
            "telephone_number": "765-408-0570",
            "fax_number": "765-453-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S WEST ST STE B",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460721848",
            "telephone_number": "765-408-0570",
            "fax_number": "765-453-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ABAGAEL",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71012910A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28232523A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipton, IN

Sources for this page

Verify at the official NPI Registry.