Individual provider Active NPI

Alexis Smith, PA-C

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1750150595
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010206 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X VA
Physician Assistant 363A00000X 0110010206 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

18230 Veronica CT
Moseley, VA 23120-1927
Phone (039) 439-0727

Other practice location 1

825 Fairfax Ave
Norfolk, VA 23507-1912
Phone (757) 446-5600

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
I20241114004701 VA Practitioner - Physician Assistant 4183158991 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC CurrentSince Oct 15, 2024 Accepting new patients
Cep America LLC CurrentSince Oct 15, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1750150595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18230 VERONICA CT",
            "city": "MOSELEY",
            "state": "VA",
            "postal_code": "231201927",
            "telephone_number": "039-439-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071912",
            "country_code": "US",
            "telephone_number": "757-446-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.