Individual provider Active NPI

Peace Nnennaya Jessa, DO

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • High Point, NC
National Provider Identifier
1275649097
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
34.010580 Issued in OH
Practice address
2401 Hickswood Rd Ste 106
High Point, NC 27265-1538
Phone
(336) 885-9675
Fax
(336) 885-9682
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 34.010580 OH Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 01737 NC

Addresses

Primary practice location

2401 Hickswood Rd Ste 106
High Point, NC 27265-1538

Mailing address

4457 State Route 159
Chillicothe, OH 45601-8620
Phone (740) 779-7813

Other practice location 1

4457 State Route 159
Chillicothe, OH 45601-8620
Phone (740) 779-7813

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151120002301 NC Practitioner - Preventive Medicine 1557368008 Reassigns benefits to 1 organization
I20240517002015 OH Practitioner - Preventive Medicine 1557368008 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
01737NCMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Apr 29, 2024 Accepting new patients
DRX High Point, PLLC CurrentSince Apr 15, 2023 Accepting new patients

Locations

1231 Eastchester Dr
High Point, NC 27265
Phone (336) 884-4050

2305 N Main St
High Point, NC 27262
Phone (336) 884-4050

2913 Wake Forest Rd
Raleigh, NC 27609
Phone (404) 960-9857

4457 State Route 159
Chillicothe, OH 45601
Phone (740) 775-7771

272 Hospital Rd
Ste 6
Chillicothe, OH 45601

3930 US Highway 23 Anx
Piketon, OH 45661
Phone (740) 779-7813

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1275649097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4457 STATE ROUTE 159",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018620",
            "telephone_number": "740-779-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 HICKSWOOD RD STE 106",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651538",
            "telephone_number": "336-885-9675",
            "fax_number": "336-885-9682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4457 State Route 159",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018620",
            "country_code": "US",
            "telephone_number": "740-779-7813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSA",
        "first_name": "PEACE",
        "middle_name": "NNENNAYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "OH",
            "license": "34.010580",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NC",
            "license": "01737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4457 State Route 159",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456018620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.