MR. KELLEY RAY JENKINS (NPI# 1275896326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275896326 |
| Entity Type | Individual |
| Full Name | MR. KELLEY RAY JENKINS |
| Credential | BC-FNP |
| Practice Address |
960 E Walnut Lawn Suite 201 Springfield MO 65807 |
| Practice Telephone | 4172694450 |
| Practice Fax Number | 4172698333 |
| Mailing Telephone | 4172694450 |
| Mailing Fax Number | 4172698333 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2006023820 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657800 | Kelley Dawn Jenkins | Psychiatry & Neurology | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2019-06-12 |
| Street Address |
960 E WALNUT LAWN SUITE 201 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124023726 | Linda R. Macgorman | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2005-06-20 |
| 1851753826 | Alina Cummins | Physician Assistant | 960 E Walnut Lawn, Springfield, MO 69580 | 2016-03-28 |
| 1124347752 | Belinda Kesterson | Physician Assistant | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2010-05-21 |
| 1629204003 | Nadir Khir | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2009-05-31 |
| 1609066950 | Jacqueline L Cook | Nurse Practitioner | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2007-08-01 |
| 1538383781 | Hussam H Alhawari | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2007-04-12 |
| 1396825303 | Hilari M Henderson | Physician Assistant | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2006-10-16 |
| 1780784298 | Donna M Roberts | Family Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2006-09-24 |
| 1225054109 | James Theodor Bonucchi | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2006-07-14 |
| 1831198993 | Jonben D Svoboda | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2005-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578178422 | Behishta Ishanzai | Nurse Practitioner | 7500 Geoint Dr, Springfield, VA 22150-7500 | 2020-09-08 |
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1255951331 | Bryndi Raye Shirley | Nurse Practitioner | 1636 S Glenstone Ave Ste 100, Springfield, MO 65804-1527 | 2020-04-20 |
| 1750900379 | Gemma Nicole D'angelo | Nurse Practitioner | 996 Stoneybrook Dr, Springfield, PA 19064-3829 | 2020-04-14 |
| 1629607882 | Melanie Herrin | Nurse Practitioner | 6230 Rolling Rd Ste J, Springfield, VA 22152-2326 | 2020-04-08 |
| 1871133520 | Deborah Ann Tully | Nurse Practitioner | 2 Medical Center Dr Ste 202, Springfield, MA 01107-1272 | 2020-01-10 |
| 1932759651 | Amanda Couchon | Nurse Practitioner | 759 Chestnut St Radiology Department, Springfield, MA 01199-0001 | 2019-09-14 |
| 1760947410 | Andrea K Leger | Nurse Practitioner | 300 Birnie Ave Ste 102, Springfield, MA 01107-1375 | 2019-02-07 |
| 1417421579 | Stephanie M Yeager | Nurse Practitioner | 3850 S National Ave Ste 700, Springfield, MO 65807-5292 | 2019-01-11 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.