Individual provider Active NPI

Kelsey McLaughlin Smith, NP

  • Pediatric Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1396460390
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024191764 Issued in VA
Practice address
1213 E Clay St
Richmond, VA 23298-5071
Phone
(804) 687-0334
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001294625 VA
Pediatric Nurse Practitioner 363LP0200X 1396460390 VA
Pediatric Nurse Practitioner 363LP0200X 0024191764 VA Primary

Addresses

Primary practice location

1213 E Clay St
Richmond, VA 23298-5071

Mailing address

10709 Cliffmore Dr
Glen Allen, VA 23060-6450
Phone (804) 687-0334

Other practice location 1

2924 Brook Rd
Richmond, VA 23220-1215
Phone (804) 828-2467

Other practice location 2

1000 E Broad St
Richmond, VA 23219-1930
Phone (804) 828-2467

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
I20250820001747 VA Practitioner - Nurse Practitioner 8325547870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Philadelphia, PA 19178

PO Box
Suite 980503
Richmond, VA 23298

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001294625VAMDRegistered Nurse
1396460390VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince May 30, 2025 Accepting new patients
Virginia Commonwealth University Health System Authority Past Accepting new patients

Locations

2924 Brook Rd
Richmond, VA 23220
Phone (804) 321-7474

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1213 E Clay St
Richmond, VA 23298
Phone (804) 827-1207

2924 Brook Rd
Ste 4
Richmond, VA 23220
Phone (804) 228-5819

1000 E Broad St
Richmond, VA 23219

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1396460390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10709 CLIFFMORE DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606450",
            "telephone_number": "804-687-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 E CLAY ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985071",
            "telephone_number": "804-687-0334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2924 Brook Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232201215",
            "country_code": "US",
            "telephone_number": "804-828-2467",
            "fax_number": "804-228-5821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232191930",
            "country_code": "US",
            "telephone_number": "804-828-2467",
            "fax_number": "804-228-5821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELSEY",
        "middle_name": "MCLAUGHLIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001294625",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "1396460390",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024191764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.