JENNA FENWCK (NPI# 1770127730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770127730 |
| Entity Type | Individual |
| Full Name | JENNA FENWCK |
| Practice Address |
15480 Annapolis Rd Bowie MD 20715-1852 |
| Mailing Address |
13204 Vanessa Ave Bowie MD 20720-4748 |
| Practice Telephone | 2408939728 |
| Mailing Telephone | 2408939728 |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2019-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
451026 | MD | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | PROSTHETIC SPECIALIST | 451026 | 01 |
| Street Address |
15480 ANNAPOLIS RD |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-1852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326426958 | Golden Days, LLC | Nurse Practitioner | 15480 Annapolis Rd, Ste 202, Bowie, MD 20715-1852 | 2015-05-15 |
| 1407209083 | Dana Lawrence | Behavioral Analyst | 15480 Annapolis Rd, Suite 202 #407, Bowie, MD 20715-1852 | 2016-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407327901 | Elise A. Maddox-mcneil | Specialist | 1513 Post Oak Dr, Bowie, MD 20721-2787 | 2018-12-09 |
| 1144426362 | Violet F Demao | Specialist | 4337 Northview Dr, Bowie, MD 20716-2601 | 2007-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153633 | Katreia Chareece White | Specialist | 5612 Saint Barnabas Rd, Oxon Hill, MD 20745-3626 | 2020-10-27 |
| 1437766482 | Natalyn Obey | Specialist | 10095 Washington Blvd N Ste 134, Laurel, MD 20723-1968 | 2020-09-24 |
| 1013528686 | Melissa Hammond | Specialist | 595 Main St Ste 235a, Laurel, MD 20707-4352 | 2020-08-16 |
| 1497373492 | Irene Marie Watkins | Specialist | 595 Main St Ste 235, Laurel, MD 20707-4352 | 2020-07-07 |
| 1073138285 | Andria Jackson | Specialist | 9560 Marlboro Pike Ste 105, Upper Marlboro, MD 20772-3770 | 2020-06-12 |
| 1467074849 | Martha Tanesha Hines | Specialist | 3407 Fort Meade Rd Ste 14, Laurel, MD 20724-2003 | 2020-05-08 |
| 1215558473 | Teraga Gross | Specialist | 5201 Ivanhoe Ave, Baltimore, MD 21212-4322 | 2020-04-29 |
| 1275168312 | Barry Staten | Specialist | 2323 Shadyside Ave, Suitland, MD 20746-4827 | 2020-03-09 |
| 1609401066 | Demarcus Tyler | Specialist | 5526 Belair Rd, Baltimore, MD 21206-3614 | 2020-03-05 |
| 1790316206 | Antjuan Mandwell Bunn | Specialist | 8147 Baltimore Ave Ste C, College Park, MD 20740-2492 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
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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.