Adreia Jenice Jessop, ARNP, CNM, IBCLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

AP60799447 Issued in WA

Practice address

300 Oak St
Kelso, WA 98626

Phone

(360) 353-5511

Fax

(360) 353-5502

NPI assigned

Sep 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Cowlitz Family Health CenterGroup PAC ID 5991696395, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajessop240348@direct.ochin.org

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.

• Cowlitz Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Longview, WA
  • NPI 1891724506
  Medicare reassignment Care Compare group NPD
• Cowlitz Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Longview, WA
  • NPI 1609524164
  NPD
• Cowlitz Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Castle Rock, WA
  • NPI 1801266481
  NPD
• Cowlitz Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Kelso, WA
  • NPI 1366790008
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1972021087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322509",
            "telephone_number": "360-353-5511",
            "fax_number": "360-353-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OAK ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "98626",
            "telephone_number": "360-353-5511",
            "fax_number": "360-353-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Cunningham Rd",
            "address_purpose": "LOCATION",
            "city": "Kelso",
            "state": "WA",
            "postal_code": "986269611",
            "country_code": "US",
            "telephone_number": "360-749-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSOP",
        "first_name": "ADREIA",
        "middle_name": "JENICE",
        "credential": "ARNP, CNM, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "WA",
            "license": "RN00157790",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60799447",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP60799447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "AP60799447",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105815",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "RN00157790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard R Imholte, D.D.S.
• Autumn Irvine, SUDP, CAAR
• Emily Jaskowiak
• Bryanna Marie Jellum, SUDP
• Jennifer M Fraser
• Joji John, RPH
• Aimee D Johnson, LPN
• Ariel Jones
• Nicole Allyse Jones, CCC-SLP
• Briana Joseph

• Women's Health Nurse Practitioner in Kelso, WA
• Providers in Kelso, WA by specialty
• Women's Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.