Active NPI
Dr Kevin M Jenkins DO Inc
- Gastroenterology Physician
- Upland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 20A4451
- Legal business name
- DR KEVIN M JENKINS DO INC
- Practice address
- 944 W Foothill Blvd
Suite B
Upland, CA 91786 - Phone
- (909) 985-2874
- Fax
- (909) 949-8314
- NPI assigned
- Sep 24, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kevin M Jenkins, DO
- Title
- President Physician
- Phone
- (909) 985-2874
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 20A4451 | CA | Primary |
Addresses
Primary practice location
944 W Foothill Blvd
Suite B
Upland, CA 91786
Mailing address
944 W Foothill Blvd
Suite B
Upland, CA 91786
Phone (909) 985-2874
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020A44510 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Dr Kevin M Jenkins DO Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Gastroenterology Physician
- Upland, CA
- NPI 1386910321
Locations
944 W Foothill Blvd
Ste B
Upland, CA 91786
Phone (909) 985-2874
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Upland, CA
- NPI 1730276163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1222214400000",
"number": "1992955272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "944 W FOOTHILL BLVD",
"address_2": "SUITE B",
"city": "UPLAND",
"state": "CA",
"postal_code": "91786",
"telephone_number": "909-985-2874",
"fax_number": "909-949-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "944 W FOOTHILL BLVD",
"address_2": "SUITE B",
"city": "UPLAND",
"state": "CA",
"postal_code": "91786",
"telephone_number": "909-985-2874",
"fax_number": "909-949-8314"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR KEVIN M JENKINS DO INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-24",
"last_updated": "2008-09-24",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
"authorized_official_telephone_number": "909-985-2874",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "20A4451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020A44510",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.