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REVONDA LASHAWN JESSUP D.P.M.
NPI 1235346172
Podiatrist - Foot & Ankle Surgery in Gastonia, NC

Active since May 17, 2007PECOS EnrolledAccepts Medicare Assignment
2721 X RAY DR, GASTONIA, NC 28054(704) 874-2255 Get Directions Write a Review

NPPES record last updated: January 24, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Revonda Lashawn Jessup D.p.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVONDA LASHAWN JESSUP D.P.M. (NPI 1235346172) is an individual foot & ankle surgery provider in Gastonia, North Carolina, licensed in North Carolina (505) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Huntersville, and is a graduate of Temple University School Of Medicine (2004).

NPPES Registry Identity

NPI1235346172
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameREVONDA LASHAWN JESSUPCredential: D.P.M.
Location Address2721 X RAY DRGastonia, NC 28054-7491
Mailing Address200 E 2nd AveGastonia, NC 28052-4358 · (704) 874-1936 · Fax (704) 865-4614
Phone(704) 874-2255
Sole ProprietorYes
Medical School CMSTemple University School Of MedicineGraduated 2004
Enumeration DateMay 17, 2007
Last NPPES UpdateJanuary 24, 2023
NPPES CertifiedJanuary 24, 2023
✔ NPI 1235346172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in NC · 505
2721 X RAY DR, Gastonia, NC 28054
Open in Google Maps ↗

Secondary Practice Location 1

Location 19601 Holly Point Dr, Suite 203Huntersville, NC 28078-4910 · Phone (704) 892-0949 · Fax (704) 987-6548

Other Identifiers 6

MedicaidNPD505SC
Other6024065NC · Cigna
Other081CPNC · Bcbs
Other1551892NC · Aetna
Other197970NC · Medcost
Medicaid5907484NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Revonda Lashawn Jessup D.p.m. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214021989
PECOS Enrollment IDI20070926000222
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Revonda Jessup reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gaston Family Health Services, Inc
Same address
Federally Qualified Health Center (FQHC)
1021 X RAY DR
Gastonia, NC 28054
  • Reassigned Medicare billing, North Carolina enrollment
  • 207 clinicians in this Medicare group
NPI 1306644315 (704) 874-1900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EUNICE ESHUN
Pharmacist
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
DR. JOHN M SCIORTINO DC
Chiropractor
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
DR. STEWART TODD PETERS D.C.
Chiropractor
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 853-5079
MRS. EUREKA A RIGBY PA
Physician Assistant
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
DR. SHANNON REED BLUMHARDT D.C.
Chiropractor
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
JACKSON DAVIS WRIGHT FNP-C
Nurse Practitioner (Family)
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
TAMMY RENEA LYNN DNP
Nurse Practitioner (Family)
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255
VAIDEHI MAHESH TRIVEDI M.D.
Pediatrics
2721 X RAY DR
GASTONIA, NC 28054
Gaston County (704) 874-2255

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revonda Jessup's NPI number?

The NPI number for Revonda Jessup is 1235346172. It was assigned to this individual provider in the NPPES registry on May 17, 2007.

Where is Revonda Jessup located?

Revonda Jessup practices at 2721 X Ray Dr, Gastonia, NC 28054. The listed phone number is (704) 874-2255.

What is Revonda Jessup's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Revonda Jessup enrolled in Medicare?

Yes. Revonda Jessup is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Revonda Jessup's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Revonda Jessup reassigns Medicare benefits to Gaston Family Health Services, Inc (Gastonia, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Revonda Jessup's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Revonda Jessup accept?

Health plans from AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC list Revonda Jessup as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Revonda Jessup was last updated on January 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.