Individual provider Active NPI

Jessica A Radley, FNP-BC

  • Family Nurse Practitioner
  • Columbus, TX
National Provider Identifier
1003057829
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
677695 Issued in TX
Practice address
2122 Highway 71 S
Columbus, TX 78934-3011
Phone
(979) 732-2318
NPI assigned
Mar 9, 2009
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 677695 TX Primary

Addresses

Primary practice location

2122 Highway 71 S
Columbus, TX 78934-3011

Mailing address

2122 Highway 71 S
Columbus, TX 78934-3011
Phone (979) 732-2318

Other identifiers 1

IdentifierTypeStateIssuer
677695OtherTXLICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CMMHjradley@columbusch.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090508000111 TX Practitioner - Nurse Practitioner 4981752524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
677695TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Community Hospital CurrentSince Jan 1, 2015 Accepting new patients
Columbus Community Hospital CurrentSince Jan 1, 2015 Accepting new patients

Locations

110 Shult Dr
Columbus, TX 78934
Phone (979) 493-7560

2122 Highway 71 S
Columbus, TX 78934
Phone (979) 732-2318

Interoperability endpoints

  • Direct secure messaging: cmmhjradley@columbusch.cernerdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1003057829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 HIGHWAY 71 S",
            "city": "COLUMBUS",
            "state": "TX",
            "postal_code": "789343011",
            "telephone_number": "979-732-2318",
            "fax_number": "979-733-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 HIGHWAY 71 S",
            "city": "COLUMBUS",
            "state": "TX",
            "postal_code": "789343011",
            "telephone_number": "979-732-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLEY",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "677695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "677695",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CMMHjradley@columbusch.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2122 Highway 71 S",
            "city": "Columbus",
            "state": "TX",
            "country_code": "US",
            "postal_code": "789343011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, TX

Sources for this page

Verify at the official NPI Registry.