Damon Keith Jessup, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN131653 Issued in GA

Practice address

1 Meadows Pkwy
Vidalia, GA 30474-8759

Phone

(912) 538-5537

Fax

(912) 538-5228

NPI assigned

Jan 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

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.

• Memorial Health Anesthetists

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1770664617
  NPD (past)

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1851578637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1303",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304751303",
            "telephone_number": "912-538-5537",
            "fax_number": "912-538-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEADOWS PKWY",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748759",
            "telephone_number": "912-538-5537",
            "fax_number": "912-538-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "DAMON",
        "middle_name": "KEITH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN131653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462913918B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462913918A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462913918C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J&C Royalty Transport
• Alexis Joan Jackson, PA-C
• Matilda Nelms Jackson, PTA
• Rhonda Mack James, RD
• Jeremy D. Wood, D.M.D, PC (Darby Dental Services)
• Jke Counseling and Psychiatric Services LLC
• Johnson Medical Transport
• Robert Eugene Johnson, MD
• Jennifer J Jones, FNP
• Hugh Frederick Jordan, D.D.S,

• Certified Registered Nurse Anesthetist in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.