Individual provider Active NPI

Cherie Rochelle Smith, PA

  • Physician Assistant
  • Fort Lee, VA
National Provider Identifier
1255823977
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001284 Issued in VA
Practice address
700 24TH St
Fort Lee, VA 23801-1716
Phone
(804) 734-9057
Fax
(804) 734-9969
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001284 VA Primary

Addresses

Primary practice location

700 24TH St
Fort Lee, VA 23801-1716

Mailing address

700 24TH St
Fort Lee, VA 23801-1716
Phone (804) 734-9057

Other identifiers 1

IdentifierTypeStateIssuer
0110001284OtherVAVIRGINIA MEDICAL LICENCE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260127004433 VA Practitioner - Physician Assistant 2466930912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Prince William Area Community Health Center IncGroup PAC ID 9436258209, 27 clinicians

Practice addresses (Care Compare)

3350 Commission CT
Woodbridge, VA 22192-1784
Phone 70368079505559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110001284VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Prince William Area Community Health Center Inc CurrentSince Jan 7, 2026 Accepting new patients
Greater Prince William Area Community Health Center Inc CurrentSince Jan 7, 2026 Accepting new patients

Locations

17739 Main St
Ste 130
Dumfries, VA 22026
Phone (703) 680-7950

9705 Liberia Ave
Ste 201
Manassas, VA 20110
Phone (703) 519-1725

3350 Commission Ct
Woodbridge, VA 22192
Phone (703) 680-7950

Organizations & group practices 2

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1255823977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9057",
            "fax_number": "804-734-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9057",
            "fax_number": "804-734-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHERIE",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAL LICENCE NUMBER",
            "identifier": "0110001284",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, VA

Sources for this page

Verify at the official NPI Registry.