Individual provider Active NPI

T'Errah Nicole Jessup, MPH, IBCLC

  • Lactation Consultant (Non-RN)
  • High Point, NC
National Provider Identifier
1841923430
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-301178 Issued in NC
Practice address
4000 Ossi CT Ste 257
High Point, NC 27265-8827
Phone
(336) 536-6466
Fax
(336) 819-5518
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X
Lactation Consultant (Non-RN) 174N00000X L-301178 NC Primary

Addresses

Primary practice location

4000 Ossi CT Ste 257
High Point, NC 27265-8827

Mailing address

350 Merrell Dr
Winston Salem, NC 27127-3819
Phone (336) 997-5896

Other practice location 1

350 Merrell Dr
Winston Salem, NC 27127-3819
Phone (336) 997-5896

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

LicenseStateTypeSpecialty
L-301178NCMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Wildflower Lactation and Postpartum Care Lactation Consultant, Non-RN CurrentSince May 26, 2024 Accepting new patients

Locations

4000 Ossi Ct
Ste 257
High Point, NC 27265
Phone (336) 447-3202

Organizations & group practices 1

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1841923430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MERRELL DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273819",
            "telephone_number": "336-997-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OSSI CT STE 257",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658827",
            "telephone_number": "336-536-6466",
            "fax_number": "336-819-5518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Merrell Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271273819",
            "country_code": "US",
            "telephone_number": "336-997-5896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "T'ERRAH",
        "middle_name": "NICOLE",
        "credential": "MPH, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NC",
            "license": "L-301178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.