Individual provider Active NPI

Regina Smith, AGPNP-BC

  • Primary Care Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1619408994
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
0024174704 Issued in VA
Practice address
5320 Providence Rd Ste 301-101
Virginia Beach, VA 23464-4122
Phone
(757) 413-7600
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024174704 VA
Gerontology Nurse Practitioner 363LG0600X 0024174704 VA
Primary Care Nurse Practitioner 363LP2300X 0024174704 VA Primary

Addresses

Primary practice location

5320 Providence Rd Ste 301-101
Virginia Beach, VA 23464-4122

Mailing address

5017 Holly Farms Dr
Virginia Beach, VA 23462-1929
Phone (408) 612-6885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210423000215 TX Practitioner - Nurse Practitioner 3375801301 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andala Medical Texas PA CurrentSince Jul 1, 2022 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Vpa of Texas PLLC CurrentSince Apr 7, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince Apr 7, 2021 Accepting new patients
Sentara Medical Group Past Accepting new patients

Locations

4600 Lockhill Selma Rd
Ste 108
San Antonio, TX 78249
Phone (210) 783-0582

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Interoperability endpoints

  • Direct secure messaging: rsmith483556@direct.sentara.net

Organizations & group practices 5

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1619408994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 HOLLY FARMS DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621929",
            "telephone_number": "408-612-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 PROVIDENCE RD STE 301-101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644122",
            "telephone_number": "757-413-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REGINA",
        "credential": "AGPNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024174704",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024174704",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024174704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.