Physician Compare National (NPI:1144491598)

HEALTHCARE PROVIDER: ANDREW WILLIAM JENKINS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1144491598
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507052297
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110901000216
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JENKINS
	Individual professional last name
Provider First Name	ANDREW
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	910 WALLACE AVE
	Group Practice or individual's line 1 address
City	LEITCHFIELD
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	427542414
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TWIN LAKES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	151322
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PERRY COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y