Healthcare Provider Details

I. General information

NPI: 1083242010
Provider Name (Legal Business Name): SHAYLA CHRISTINE JENKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAYLA MCELYEA MD

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11644 W 75TH ST STE 103
SHAWNEE KS
66214-1300
US

IV. Provider business mailing address

11644 W 75TH ST STE 103
SHAWNEE KS
66214-1300
US

V. Phone/Fax

Practice location:
  • Phone: 913-248-9965
  • Fax: 855-521-9687
Mailing address:
  • Phone: 913-248-9965
  • Fax: 855-521-9687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-48302
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: