Active NPI
Shawn D Jessup
- Pharmacotherapy Pharmacist
- Thomasville, NC
National Provider Identifier
1265716740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 24156
- Practice address
- 1131 Randolph St
Thomasville, NC 27360-5749 - Phone
- (336) 474-8900
- NPI assigned
- Oct 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 24156 | NC | Primary |
| Pharmacist | 183500000X | 24156 | NC |
Addresses
Primary practice location
1131 Randolph St
Thomasville, NC 27360-5749
Mailing address
165 Holly Tree Rd
Claudville, VA 24076-3351
Phone (540) 392-8198
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24156 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1265716740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 HOLLY TREE RD",
"city": "CLAUDVILLE",
"state": "VA",
"postal_code": "240763351",
"telephone_number": "540-392-8198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 RANDOLPH ST",
"city": "THOMASVILLE",
"state": "NC",
"postal_code": "273605749",
"telephone_number": "336-474-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSUP",
"first_name": "SHAWN",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-03",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NC",
"license": "24156",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "24156",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomasville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.