AUDREY F JESSUP (NPI# 1831527233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831527233 |
| Entity Type | Individual |
| Full Name | AUDREY F JESSUP |
| Practice Address |
1471 Deer Rd Mt Airy NC 27030-1471 |
| Mailing Address |
1471 Deer Rd Mount Airy NC 27030-7407 |
| Practice Telephone | 3363513401 |
| Practice Fax Number | 3363514344 |
| Mailing Telephone | 3363513401 |
| Mailing Fax Number | 3363514344 |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 1722 | NC | Residential Treatment Facilities |
| Street Address |
1471 DEER RD |
| City | MT AIRY |
| State | NC |
| Zip Code | 27030-1471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669800025 | Genesis Rehab. Services | Residential Treatment Facility, Physical Disabilities | 1471 Deer Rd, Mt Airy, NC 27030-1471 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669800025 | Genesis Rehab. Services | Residential Treatment Facility, Physical Disabilities | 1471 Deer Rd, Mt Airy, NC 27030-1471 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883170 | Vision of Therapeutic Development, Inc. | Residential Treatment Facility, Physical Disabilities | 35 Southern Village Dr, Roxboro, NC 27573-2516 | 2019-10-24 |
| 1144760844 | Tjt Family Home | Residential Treatment Facility, Physical Disabilities | 116 Leanne Dr, Greenville, NC 27858-8126 | 2017-02-28 |
| 1104361518 | Senior Care Carolinas | Residential Treatment Facility, Physical Disabilities | 9640 Gilead Grove Rd, Huntersville, NC 28078-2289 | 2016-12-21 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1417329749 | Troy Leigh Lockamy | Residential Treatment Facility, Physical Disabilities | 300 Meredith Dr, Durham, NC 27713-2282 | 2015-10-26 |
| 1689044638 | April Campbell Lee | Residential Treatment Facility, Physical Disabilities | 3204 Huntleigh Dr, Raleigh, NC 27604-3310 | 2015-10-03 |
| 1538545025 | Viktoriya Semenova | Residential Treatment Facility, Physical Disabilities | 1405 Falls Church Rd, Raleigh, NC 27609-4015 | 2015-08-06 |
| 1356744932 | Z & M Residential Villa 1 | Residential Treatment Facility, Physical Disabilities | 10298 Pasture Rd, Middlesex, NC 27557-7200 | 2014-09-26 |
| 1841608866 | Noa Human Services LLC 3 | Residential Treatment Facility, Physical Disabilities | 1847 Waycross Drive, Winston Salem, NC 27106 | 2014-07-23 |
| 1194150417 | Azalea Garden | Residential Treatment Facility, Physical Disabilities | 413 Culvert St, Apex, NC 27502-1731 | 2013-09-05 |
| Find all providers with the same taxonomy | ||||
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| 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.