KELLY JENKINS (PT, DPT) – Physical Therapist, NPI 1235936618

KELLY JENKINS (PT, DPT) is a healthcare provider. based in Loganville, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 42798 (FL). The NPI Number for KELLY JENKINS (PT, DPT) is 1235936618

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
KELLY JENKINS (PT, DPT)
NPI
1235936618
Phone
(770) 363-4354
Address
5121 CENTER HILL CHURCH RD
Enumeration Date
25 February 2025
Last Update Date
25 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3867560077
Graduation Year
2024 (2 years ago)
PAC ID
8426571472
Group Practice PAC ID
6901884519
Professional Enrollment ID
I20250331001730
Address ID
FL321274226PO733XXAVEX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for KELLY JENKINS (PT, DPT)

  • 5121 CENTER HILL CHURCH RD

    LOGANVILLE, GA 300527206

    Phone: (770) 363-4354

    Type: Mailing

  • 733 DUNLAWTON AVE STE 103

    PORT ORANGE, FL 321274226

    Phone: (386) 756-0077

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250331001730IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30052)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901884519View full group profile
NameSpecialtyState
-CA
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
-FL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeAZ

Reviews

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Frequently asked questions

What unique ID ties claims to KELLY JENKINS (PT, DPT)?
NPI 1235936618 is assigned to KELLY JENKINS (PT, DPT) under the national enumeration system.
Does this profile mean KELLY JENKINS (PT, DPT) is currently active?
Yes — KELLY JENKINS (PT, DPT) appears active in the national provider directory.
What kind of provider is KELLY JENKINS (PT, DPT)?
The page reflects Physical Therapist for KELLY JENKINS (PT, DPT). Clinical services aligned with this taxonomy classification.
Does KELLY JENKINS (PT, DPT) practice in Georgia?
You will see Loganville, Georgia on file for KELLY JENKINS (PT, DPT) alongside any extra practice locations.
Is KELLY JENKINS (PT, DPT) a real provider?
This page reflects official NPPES data for NPI 1235936618. Always confirm identity and privileges with the practice and licensing boards.

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