NPIMap

Individual provider Active NPI

Christina Dawn Jenkins, NP

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1992388573
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG02210040 Issued in SC
Practice address
301 Halton Rd
Greenville, SC 29607-3496
Phone
(864) 692-6699
NPI assigned
May 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG02210040 SC Primary

Addresses

Primary practice location

301 Halton Rd
Greenville, SC 29607-3496

Mailing address

238 Butler Rd
Williamston, SC 29697-9616
Phone (910) 265-1187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230108000008 SC Practitioner - Nurse Practitioner 3971973918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Pruitthealth Hospice IncGroup PAC ID 2264344217, 42 clinicians

Practice addresses (Care Compare)

2051 Elijah Ludd Rd
Suite 1
Florence, SC 29501-3942
Phone (843) 662-8633

301 Halton Rd
Suite B
Greenville, SC 29607-3498
Phone (864) 962-6699

Hospital & facility affiliations

  • Pruitthealth Home Health-Columbia Home health agency, Columbia, SC, CCN 427130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG02210040SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc. CurrentSince Aug 18, 2022 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Aug 18, 2022 Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

2051 Elijah Ludd Rd
Ste 1
Florence, SC 29501
Phone (843) 573-8623

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 3

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1992388573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 BUTLER RD",
            "city": "WILLIAMSTON",
            "state": "SC",
            "postal_code": "296979616",
            "telephone_number": "910-265-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073496",
            "telephone_number": "864-692-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHRISTINA",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "AG02210040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.