Edith Jenkins

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71007161A Issued in IN

Practice address

1515 Forest Ave
Calumet City, IL 60409-6218

Phone

(708) 743-0365

Fax

(708) 432-6699

NPI assigned

Feb 2, 2017

Sex

Female

Sole proprietor

Yes

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 IN, IL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Health Services, LLC Home health agency, Lansing, IL, CCN 148287
• Medpro Health Providers Home health agency, Tinley Park, IL, CCN 148246
• Professional Home Care Advantage Inc Home health agency, Chicago, IL, CCN 147660

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edith.jenkins.1@22475.direct.athenahealth.com
• Direct secure messaging: edith.jenkins.1@12268.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/683/brand/4/csg/61/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/22475/brand/1/csg/1/fhir/r4

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.

• Ej Health Solutions Inc

  • Home Health Agency
  • Calumet City, IL
  • NPI 1790382117

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Chicago Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Orland Park, IL
  • NPI 1285972505
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1174925663

  Multi-Specialty

  Medicare reassignment NPD
• Edgewater Systems for Balanced Living, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gary, IN
  • NPI 1588705784

  Multi-Specialty

  Medicare reassignment NPD
• Informe HC Specialists, LLC

  • Internal Medicine Physician
  • Dyer, IN
  • NPI 1255917647

  Multi-Specialty

  Medicare reassignment NPD
• Informe Healthcare in, LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1992276638

  IN, Multi-Specialty

  Medicare reassignment NPD
• Housecall Doctors. P.C.

  • Internal Medicine Physician
  • Merrillville, IN
  • NPI 1396050142
  Medicare reassignment
• Vpa PC

  • Family Medicine Physician
  • Burr Ridge, IL
  • NPI 1912521071

  Multi-Specialty

  NPD
• Edgewater Systems for Balanced Living, Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1093670648
  NPD
• Housecall Doctors PC

  • Podiatrist
  • Merrillville, IN
  • NPI 1407278377

  Multi-Specialty

  NPD (past)

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

• Community Health Services LLC

  • Home Health Agency
  • Lansing, IL
  • NPI 1316275779
  Care Compare affiliation
• Medpro Health Providers LLC

  • Home Health Agency
  • Tinley Park, IL
  • NPI 1073820049
  Care Compare affiliation
• Professional Home Care Advantage, Inc.

  • Home Health Agency
  • Lansing, IL
  • NPI 1801845896
  Care Compare affiliation

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577577600000",
    "number": "1982142527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 FOREST AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604096218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 FOREST AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604096218",
            "telephone_number": "708-743-0365",
            "fax_number": "708-432-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "EDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007161A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F01171312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Injury Centers of Illinois
• Integrated Dermatology of Calumet City LLC
• Integrity Home Health Care Services, Inc
• It'S About Change Sober Living, Inc.
• Jaytrust LLC
• Daniel Johnson, PHARM. D
• Lanise Johnson
• Meredith Johnson
• Jollyglo International Limited
• Mary Jones Randle

• Nurse Practitioner in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2019; 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.