Individual provider Active NPI

Anna Regina Jessup, RN, FNP-C

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1760692370
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
669251 Issued in TX
Practice address
2120 N Mays St
Suite 450
Round Rock, TX 78664-2192
Phone
(512) 828-4405
Fax
(512) 828-4412
NPI assigned
May 23, 2007
Last updated
Dec 28, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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 669251 TX Primary

Addresses

Primary practice location

2120 N Mays St
Suite 450
Round Rock, TX 78664-2192

Mailing address

2120 N Mays St
Suite 450
Round Rock, TX 78664-2192
Phone (512) 828-4405

Other identifiers 1

IdentifierTypeStateIssuer
0021NPOtherTXBCBS

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
669251TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rapidcare Clinic PA Past Accepting new patients
Rapid Care Clinic PA Past Accepting new patients
Wellmed Medical Group, P.a. Past Accepting new patients
Rapid Care Clinic PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anna.jessup.1@12600.direct.athenahealth.com

Organizations & group practices 4

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1760692370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 N MAYS ST",
            "address_2": "SUITE 450",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642192",
            "telephone_number": "512-828-4405",
            "fax_number": "512-828-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 N MAYS ST",
            "address_2": "SUITE 450",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642192",
            "telephone_number": "512-828-4405",
            "fax_number": "512-828-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "ANNA",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "669251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0021NP",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.