IndividualActive
Tracy Jenkins, CEO
NPI 1790419075 · Driver · Philadelphia, PA
Provider details
- NPI number
- 1790419075
- Entity type
- Individual
- Primary specialty
- DriverOther Service Providers
- Credential
- CEO
- Sex
- Male
- Sole proprietor
- No
- License
- 22428191 (PA)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6529 N Woodstock St
Philadelphia, PA 19138-3114
Phone: (267) 345-5968
Street-level locationGet directions
Mailing address
6529 N Woodstock St
Philadelphia, PA 19138-3114
Registry dates
- Enumerated
- 2022-07-13
- Last updated
- 2022-07-13
- Certified
- 2022-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.