NPIMap

Individual provider Active NPI

Angelica Maria Smith, NP

  • Nurse Practitioner
  • Colonial Heights, VA
National Provider Identifier
1376911230
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024172870 Issued in VA
Practice address
436 Clairmont CT
Suite 100
Colonial Heights, VA 23834-1765
Phone
(804) 526-2121
Fax
(804) 520-2617
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024172870 VA Primary

Addresses

Primary practice location

436 Clairmont CT
Suite 100
Colonial Heights, VA 23834-1765

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 526-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151117002213 VA Practitioner - Nurse Practitioner 1355651621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
American Medical Missionary College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

436 Clairmont CT
Suite 100
Colonial Heights, VA 23834-1765
Phone (804) 526-2121

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Primary Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

436 Clairmont Ct
Ste 100
Colonial Hgts, VA 23834
Phone (804) 526-2121

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1376911230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-526-2121",
            "fax_number": "804-520-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CLAIRMONT CT",
            "address_2": "SUITE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341765",
            "telephone_number": "804-526-2121",
            "fax_number": "804-520-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELICA",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024172870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.