DR. JOHN L JR. JENNINGS (M.D.) – Dermatology Physician, NPI 1891776753
Dermatology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JOHN L JR. JENNINGS (M.D.)
801, York Street, Manitowoc, Manitowoc County, Wisconsin, 54220, United States
MANITOWOC, WI 542204630
Phone: (920) 663-9008
Fax: (920) 684-1439
Type: Mailing
2613, North Hospital Road, Goldsboro, Wayne County, North Carolina, 27534, United States
GOLDSBORO, NC 27534
Phone: (919) 736-0222
Fax: (919) 736-0223
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: 2009-04-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090403000482 | I | Dermatology | NC | TBD |
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.
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 54220)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Physician Assistant | VA | |
| - | VA | |
| D E R M A T O L O G Y | TX | |
| - | WI | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | WA |
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