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DR. CRYSTAL L JENCKS MD NPI 1508877788


NPI Information

NPI: 1508877788
Provider Name: DR. CRYSTAL L JENCKS, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: LUTHERAN MEDICAL GROUP LLC

PECOS Registration: Yes

Address:
11115 LIMA RD
FORT WAYNE, IN
ZIP 46818
Phone: (260) 478-4201
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DR. Crystal L Jencks, MD is a family medicine in Fort Wayne, IN with 18 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Crystal L Jencks, MD NPI is 1508877788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11115 LIMA RD
FORT WAYNE, IN
ZIP 46818-536
Phone: (260) 478-4201
Fax: (260) 458-3248

The NPI 1508877788 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 12/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine11013271INDIANANo
2207Q00000XFamily MedicineM-12895IDAHONo
3207Q00000XFamily Medicine01066698INDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.