| Revonda Lashawn Jessup, DPM | |
|
2721 X Ray Dr, Gastonia, NC 28054-7491 | |
| (704) 874-2255 | |
| Not Available |
| Full Name | Revonda Lashawn Jessup |
|---|---|
| Gender | Female |
| Speciality | Podiatry |
| Experience | 21 Years |
| Location | 2721 X Ray Dr, Gastonia, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235346172 | NPI | - | NPPES |
| NPD505 | Medicaid | SC | |
| 6024065 | Other | NC | CIGNA |
| 081CP | Other | NC | BCBS |
| 1551892 | Other | NC | AETNA |
| 197970 | Other | NC | MEDCOST |
| 5907484 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 505 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gaston Family Health Services Inc | 5496733925 | 87 |
| Provider Name | Gaston Family Health Services Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1215932215 PECOS PAC ID: 5496733925 Enrollment ID: O20040712000470 |
| Mailing Address | Practice Location Address |
|---|---|
| Revonda Lashawn Jessup, DPM 200 E 2nd Ave, Gastonia, NC 28052-4358 Ph: (704) 874-1936 | Revonda Lashawn Jessup, DPM 2721 X Ray Dr, Gastonia, NC 28054-7491 Ph: (704) 874-2255 |
Mr. John Kersey Throckmorton, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 111 E 3rd Ave, Gastonia, NC 28052 Phone: 704-874-3300 Fax: 704-874-0065 | |
Melanie Eubanks, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1421a E Franklin Blvd, Gastonia, NC 28054 Phone: 704-674-9272 | |
Mr. Robert Christopher Olson, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2345 Court Drive, Gastonia, NC 28054 Phone: 704-865-0077 Fax: 704-867-6401 | |
Dr. David Russell Kirlin I, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 251 Wilmot Dr, Gastonia, NC 28054 Phone: 704-861-0425 Fax: 704-861-0274 | |
Dr. Wagner Gilbert Santiago, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 251 Wilmot Dr, Gastonia, NC 28054 Phone: 704-861-0425 Fax: 704-861-0274 | |
Dr. Randall J Contento, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 251 Wilmot Dr, Gastonia, NC 28054 Phone: 704-861-0425 |