DEREK RANDALL JENKINS (NPI# 1669613907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669613907 |
| Entity Type | Individual |
| Full Name | DEREK RANDALL JENKINS |
| Credential | M.D. |
| Practice Address |
1 Kettle Point Ave East Providence RI 02914-5375 |
| Mailing Address |
Po Box 1119 Providence RI 02901-1119 |
| Practice Telephone | 4014539032 |
| Practice Fax Number | 4018615812 |
| Mailing Telephone | 4014539032 |
| Mailing Fax Number | 4018615812 |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2019-02-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 55660 | MN | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 106300 | MN | Allopathic & Osteopathic Physicians |
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
16277 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ENROLLED | 05 | |
| IA | ENROLLED | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366832412 | Derek Jenkins | Physical Therapist | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2015-01-28 |
| Street Address |
1 KETTLE POINT AVE |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-5375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467443051 | Brett D Owens | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2005-11-02 |
| 1124642285 | Kyra Gabow | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-06-04 |
| 1033742564 | Danielle Barry | Nurse Practitioner | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-02-12 |
| 1558991737 | Chloe Hawkridge Sienkewicz | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-01-16 |
| 1972162113 | Kirsten Harrington | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2019-06-11 |
| 1093373888 | Melissa Viens | Occupational Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2019-06-05 |
| 1184184012 | Kasey Elizabeth Cameron | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914 | 2019-03-25 |
| 1417452442 | Michael Coyne | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2018-03-30 |
| 1932608692 | Jason R Schoenfelder | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2018-02-08 |
| 1811413404 | University Orthopedics, Inc. | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2017-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205886272 | Richard Limbird | Orthopaedic Surgery | 2 Dudley St, Suite 200, Providence, RI 02905-3236 | 2006-05-11 |
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
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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.