Individual provider Active NPI

Carolyn Mansour Herrera, PA-C

  • Physician Assistant
  • Colonial Heights, VA
National Provider Identifier
1477834455
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005621 Issued in VA
Practice address
1260 Temple Ave
Colonial Heights, VA 23834-2984
Phone
(804) 518-2597
NPI assigned
Sep 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 0110005621 VA Primary

Addresses

Primary practice location

1260 Temple Ave
Colonial Heights, VA 23834-2984

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170609000918 DC Practitioner - Physician Assistant 1153550967 Reassigns benefits to 1 organization
I20170717003132 VA Practitioner - Physician Assistant 1153550967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Richmond Medical Group PLLCGroup PAC ID 9931011434, 315 clinicians

Practice addresses (Care Compare)

11020 Hull St Rd
Midlothian, VA 23112-3200
Phone (804) 744-6310

12 N Thompson St
Richmond, VA 23221-2718
Phone (804) 359-1337

12101 S Chalkley Rd
Chester, VA 23831-3755
Phone (804) 796-3636

1260 Temple Ave
Colonial Heights, VA 23834-2984
Phone (804) 518-2597

2300 E Parham Rd
Henrico, VA 23228-3118
Phone (804) 264-7808

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

8110 Midlothian Tpke
North Chesterfield, VA 23235-5116
Phone (804) 320-8160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110005621VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Jun 1, 2017 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Jun 1, 2017 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

1260 Temple Ave
Colonial Heights, VA 23834
Phone (804) 418-2597

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

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": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1477834455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 TEMPLE AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342984",
            "telephone_number": "804-518-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "CAROLYN",
        "middle_name": "MANSOUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1260 Temple Ave",
            "city": "Colonial Heights",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238342984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.