Individual provider Active NPI

Donella Jenkins, M.D.

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1942203609
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A54017 Issued in CA
Practice address
2425 Alhambra Blvd
Sacramento, CA 95817-1110
Phone
(916) 313-8400
Fax
(916) 436-5559
NPI assigned
May 24, 2005
Last updated
May 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A54017 CA Primary

Addresses

Primary practice location

2425 Alhambra Blvd
Sacramento, CA 95817-1110

Mailing address

777 12TH St
Ste 250
Sacramento, CA 95814-1929
Phone (916) 469-4690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070409000401 CA Practitioner - Family Practice 7810091451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54017CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Doctors on Duty Past Accepting new patients
Santa Cruz Doctors on Duty Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1942203609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 12TH ST",
            "address_2": "STE 250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958141929",
            "telephone_number": "916-469-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 ALHAMBRA BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171110",
            "telephone_number": "916-313-8400",
            "fax_number": "916-436-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DONELLA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.