REVONDA LASHAWN JESSUP (NPI# 1235346172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235346172 |
| Entity Type | Individual |
| Full Name | REVONDA LASHAWN JESSUP |
| Credential | D.P.M. |
| Practice Address |
9601 Holly Point Dr Suite 203 Huntersville NC 28078-4910 |
| Practice Telephone | 7048920949 |
| Practice Fax Number | 7049876548 |
| Mailing Telephone | 7048920949 |
| Mailing Fax Number | 7049876548 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2011-03-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
505 | NC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NPD505 | 05 | |
| NC | BCBS | 081CP | 01 |
| NC | 5907484 | 05 | |
| NC | AETNA | 1551892 | 01 |
| NC | MEDCOST | 197970 | 01 |
| NC | CIGNA | 6024065 | 01 |
| Street Address |
9601 HOLLY POINT DR SUITE 203 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-4910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588923775 | Khanh Le Eagle | General Practice | 9601 Holly Point Dr, Huntersville, NC 28078-4910 | 2012-05-09 |
| 1265733687 | Jessup Foot and Ankle Specialists, Pa | Podiatrist | 9601 Holly Point Dr, Suite 203, Huntersville, NC 28078-4910 | 2010-11-17 |
| 1962672691 | Toya C Foggie | Speech-Language Pathologist | 9601 Holly Point Dr, Huntersville, NC 28078-4910 | 2008-03-10 |
| 1275726838 | Joy H. Bell | Speech-Language Pathologist | 9601 Holly Point Dr, Suite 200, Huntersville, NC 28078-4910 | 2007-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346878410 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 16419 Northcross Dr Ste A, Huntersville, NC 28078-5009 | 2020-04-01 |
| 1285702597 | Mark Alan Quist | Podiatrist | 16419 Northcross Dr, Suite A, Huntersville, NC 28078-5004 | 2006-12-04 |
| 1538155015 | Foot & Ankle Associates Pllc | Podiatrist | 15419 Hodges Cir, Suite # 200, Huntersville, NC 28078-6557 | 2005-09-21 |
| 1265733687 | Jessup Foot and Ankle Specialists, Pa | Podiatrist | 9601 Holly Point Dr, Suite 203, Huntersville, NC 28078-4910 | 2010-11-17 |
| 1811038375 | Carolina Foot & Ankle of Huntersville, PC | Podiatrist | 16419 Northcross Dr, Suite A, Huntersville, NC 28078-5004 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696834 | Instride Foot & Ankle Specialists, Pllc | Podiatrist | 6341 Cook Ave Ste A, Clemmons, NC 27012-9380 | 2020-07-15 |
| 1497376370 | Carolina Foot & Ankle of Huntersville, PC | Podiatrist | 10310 Couloak Dr Ste 200, Charlotte, NC 28216-7673 | 2020-05-01 |
| 1346861614 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 1506 E Franklin St Ste 104, Chapel Hill, NC 27514-2825 | 2020-04-28 |
| 1316576283 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 3800 Highway 49 South, Harrisburg, NC 28075 | 2020-04-03 |
| 1386289841 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 700 Tilghman Dr Ste 722, Dunn, NC 28334-5519 | 2019-11-08 |
| 1881244168 | Unc Physicians Network Group Practices, LLC | Podiatrist | 1505 Sw Cary Pkwy Ste 200, Cary, NC 27511-6219 | 2019-09-18 |
| 1669022950 | Unc Physicians Network Group Practices, LLC | Podiatrist | 501 Health Park Dr Ste 180, Garner, NC 27529-7051 | 2019-09-18 |
| 1861042152 | Unc Physicians Network Group Practices, LLC | Podiatrist | 6602 Knightdale Blvd Ste 203, Knightdale, NC 27545-6567 | 2019-09-18 |
| 1326518630 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 114 N Northwood St, Wallace, NC 28466 | 2018-11-29 |
| 1518452143 | Foot and Ankle Associates of Nc, Pllc | Podiatrist | 2130 Forest Hills Rd W Ste C, Wilson, NC 27893-3681 | 2018-06-26 |
| Find all providers with the same taxonomy | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
Please comment or provide details below to improve the information on REVONDA LASHAWN JESSUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.