NPI 1669613907 · live from the CMS NPI Registry
Derek Randall Jenkins, M.D.
Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery in East Providence, RI. National Provider Identifier 1669613907, active.
NPI record
| NPI | 1669613907 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery 207XS0114X |
| Practice location | 1 Kettle Point Ave, East Providence, RI 02914 |
| Practice phone | 401-453-9032 |
| Mailing address | Po Box 1119, Providence, RI 02901 |
| Enumerated | March 17, 2009 |
| Last updated | February 12, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery | 207X00000X | 106300 (MN) |
| Orthopaedic Surgery | 207X00000X | 55660 (MN) |
| Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery primary | 207XS0114X | 16277 (NH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.