Individual provider Active NPI

Brittani Danielle Jessup, FNP-BC

  • Family Nurse Practitioner
  • Stony Creek, VA
National Provider Identifier
1124879150
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024189948 Issued in VA
Practice address
12454 Hartley Street
Stony Creek, VA 23882
Phone
(434) 246-6100
Fax
(434) 597-4567
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 0024189948 VA Primary

Addresses

Primary practice location

12454 Hartley Street
Stony Creek, VA 23882

Mailing address

15004 Wilkinson Rd
Dewitt, VA 23840-3217
Phone (804) 894-3566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240712001237 VA Practitioner - Nurse Practitioner 7810432952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stony Creek Community Health CenterGroup PAC ID 5395710057, 3 clinicians

Practice addresses (Care Compare)

12454 Hartley St
Stony Creek, VA 23882-3302
Phone (804) 246-6100

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024189948VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Creek Community Health Center CurrentSince Jun 19, 2025 Accepting new patients
Stony Creek Community Health Center CurrentSince Jun 19, 2025 Accepting new patients

Locations

12454 Hartley St
Stony Creek, VA 23882
Phone (434) 246-6100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAGDAA/Endpoint/IAGDAA

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1124879150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15004 WILKINSON RD",
            "city": "DEWITT",
            "state": "VA",
            "postal_code": "238403217",
            "telephone_number": "804-894-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12454 HARTLEY STREET",
            "city": "STONY CREEK",
            "state": "VA",
            "postal_code": "23882",
            "telephone_number": "434-246-6100",
            "fax_number": "434-597-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "BRITTANI",
        "middle_name": "DANIELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Creek, VA

Sources for this page

Verify at the official NPI Registry.