Individual provider Active NPI

Rebecca Marie Smith, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Allen, VA
National Provider Identifier
1720693740
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024179881 Issued in VA
Practice address
4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324
Phone
(804) 303-9622
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024179881 VA Primary

Addresses

Primary practice location

4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324

Mailing address

4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324
Phone (804) 303-9622

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
I20210923002528 VA Practitioner - Nurse Practitioner 4284031840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zoe Therapy Services, LLCGroup PAC ID 2769603901, 31 clinicians

Practice addresses (Care Compare)

4191 Innslake Dr
Suite 211
Glen Allen, VA 23060-3324
Phone 8043039622104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Zoe Therapy Services, LLC CurrentSince Sep 6, 2022 Accepting new patients
Zoestyle Medicine CurrentSince Sep 25, 2022 Accepting new patients

Locations

4191 Innslake Dr
Glen Allen, VA 23060

4191 Innslake Dr
Ste 211
Glen Allen, VA 23060
Phone (804) 303-9622

4191 Innslake Dr
Ste 212
Glen Allen, VA 23060
Phone (804) 303-9622

Interoperability endpoints

  • Direct secure messaging: zoerva.rebeccasmith@158312.advancedmd-direct.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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1720693740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024179881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.