MARK A. JENKINS, MD (NPI# 1417113424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417113424 |
| Entity Type | Organization |
| Organization Name | MARK A. JENKINS, MD |
| Practice Address |
1818 Richardson Dr Suite E Reidsville NC 27320-5451 |
| Practice Telephone | 3366340095 |
| Practice Fax Number | 3366160320 |
| Mailing Telephone | 3366340095 |
| Mailing Fax Number | 3366160320 |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | DR. MARK A JENKINS (OWNER) |
| Authorized Official Telephone | 3366340095 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 9400533 | NC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 45870 | 01 |
| NC | PARTNERS | 8284 | 01 |
| NC | 8945870 | 05 | |
| NC | UHC | 1701768 | 01 |
| NC | UPIN | D44070 | 01 |
| NC | MEDCOST | 52454 | 01 |
| Street Address |
1818 RICHARDSON DR SUITE E |
| City | REIDSVILLE |
| State | NC |
| Zip Code | 27320-5451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255334181 | Belmont Medical Associates Pllc | Internal Medicine | 1818 Richardson Dr, Ste A, Reidsville, NC 27320-5450 | 2005-05-24 |
| 1275997546 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1818 Richardson Dr, Suite C, Reidsville, NC 27320-5451 | 2016-04-12 |
| 1649600024 | Moses Cone Physician Services, Inc | Urology | 1818 Richardson Dr, Ste F, Reidsville, NC 27320-5451 | 2013-11-20 |
| 1801191754 | Samantha Jackson | Physician Assistant | 1818 Richardson Dr, Reidsville, NC 27320-5451 | 2011-01-24 |
| 1639312879 | Northern Triad Surgical Associates, Pllc | Surgery | 1818 Richardson Dr, Ste. E, Reidsville, NC 27320-5451 | 2009-04-17 |
| 1982868865 | Junell Carol Koberlein | Family Medicine | 1818 Richardson Dr, Ste. A, Reidsville, NC 27320-5451 | 2008-07-10 |
| 1952595373 | Benjamin L Mann | Physician Assistant | 1818 Richardson Dr, Suite A, Reidsville, NC 27320-5451 | 2007-08-29 |
| 1629092184 | Mark A Jenkins | Surgery | 1818 Richardson Dr, Suite E, Reidsville, NC 27320-5451 | 2006-07-27 |
| 1750317665 | William Stanford Kallam | Dentist | 1818 Richardson Dr, Suite D, Reidsville, NC 27320-5451 | 2006-06-23 |
| 1700825486 | Brent Christian Ziegler | Surgery | 1818 Richardson Dr, Suite E, Reidsville, NC 27320-5450 | 2006-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417576620 | Professional Vision Care, Od, Pllc | Optometrist | 1624 Nc #14 Highway, Reidsville, NC 27320 | 2020-04-09 |
| 1538796966 | Dabney Varner Porter | Speech-Language Pathologist | 613 S. Main St., Reidsville, NC 27320 | 2020-03-25 |
| 1053868463 | Marlon Nolen | Social Worker | 425 Nc-65, Reidsville, NC 27320 | 2016-09-01 |
| 1659741346 | Gepernard Tania Polidor | Social Worker | 405 Nc-65, Reidsville, NC 27320 | 2015-10-07 |
| 1548687064 | Angel Allen | Skilled Nursing Facility | 255 Penn Lake Dr, Reidsville, NC 27320 | 2014-03-21 |
| 1801234844 | Remmsco | Substance Abuse Rehabilitation Facility | 106 N. Franklin St, Reidsville, NC 27320 | 2013-06-12 |
| 1861733669 | The Free Clinic of Rockingham County, Inc | Clinic/Center | 315 S. Main Street, Reidsville, NC 27320 | 2013-03-05 |
| 1396094173 | Helen Elizabeth Brooks | Nurse Practitioner | 502 South Scales Street, Reidsville, NC 27320 | 2012-09-07 |
| 1952650327 | Ashlee Place | Assisted Living Facility | 538 Warriner Street, Reidsville, NC 27320 | 2012-08-31 |
| 1558638536 | Tracey Caroline Cook | Pharmacist | 1623 Way, Reidsville, NC 27320 | 2011-11-19 |
| Find all providers in zip 27320 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669516068 | Robert Warren Woodward | Specialist | 637 Parkway Blvd, Reidsville, NC 27320-6103 | 2007-02-18 |
| 1710947403 | Donald Franklin Kennedy Jr. | Specialist | 131 Memorial Drive, Reidsville, GA 30453 | 2006-03-25 |
| 1043504624 | Southern Surgical Providers, P.C. | Specialist | 247a S Main St, Reidsville, GA 30453-4605 | 2011-06-01 |
| 1023169281 | Rockingham Medical & Kidney Care,pllc | Specialist | 1352 W Harrison St, Reidsville, NC 27320-2606 | 2007-01-15 |
| 1730276890 | Family Tree Ob Gyn, Pa | Specialist | 520 Maple Ave, Suite C, Reidsville, NC 27320-4652 | 2006-10-09 |
| 1578500609 | Paul I Ray | Specialist | 247 S Main St, Reidsville, GA 30453-4605 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989812 | Ryan Graham | Specialist | 405 Avett Dr, Durham, NC 27703-8291 | 2020-07-14 |
| 1184248197 | Tunishia Chanel Parks | Specialist | 106 Daniels Ave, Battleboro, NC 27809-7503 | 2020-06-05 |
| 1306460811 | Ashley Davis | Specialist | 765 Highland Oaks Dr Ste 100, Winston Salem, NC 27103-7100 | 2020-06-01 |
| 1083236996 | Latisha Isheema Buchanan | Specialist | 3215 Guess Rd Ste 101, Durham, NC 27705-2668 | 2020-05-13 |
| 1356962872 | Katherine Joy Griffin | Specialist | 1112 Bottle Brush Ln, Harrisburg, NC 28075-6716 | 2020-05-06 |
| 1174158315 | Shanese Spaulding | Specialist | 309 N Elm St, Lumberton, NC 28358-5649 | 2020-03-09 |
| 1417590290 | Sarah Lyn Granahan | Specialist | 107 Windel Dr Ste 205, Raleigh, NC 27609-4471 | 2019-10-23 |
| 1215580949 | Felisha Cheadle | Specialist | 240 Appalachian Dr, Raeford, NC 28376-6342 | 2019-07-22 |
| 1962062240 | Shenika Twanet Judd | Specialist | 724 N Reilly Rd Ste C, Fayetteville, NC 28303-6042 | 2019-06-18 |
| 1033676358 | Suzanne Lynn Washburn | Specialist | 307 Barcelona Drive 26e, Fayetteville, NC 28303-5768 | 2019-02-22 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 27320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.