Individual provider Active NPI

Jennifer Colleen Smith, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hopewell, VA
National Provider Identifier
1811732217
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024190276 Issued in VA
Practice address
411 W Randolph Rd
Hopewell, VA 23860-2938
Phone
(804) 641-7404
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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 0024190276 VA Primary

Addresses

Primary practice location

411 W Randolph Rd
Hopewell, VA 23860-2938

Mailing address

1628 Peachtree Dr
North Prince George, VA 23860-7609
Phone (757) 528-3046

Other practice location 1

140 E Ferrell St
South Hill, VA 23970-2102
Phone (434) 584-5400

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
I20250602002144 VA Practitioner - Nurse Practitioner 2668981689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

140 E Ferrell St
South Hill, VA 23970-2102
Phone (434) 584-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024190276VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Mar 2, 2025 Accepting new patients

Locations

411 W Randolph Rd
Hopewell, VA 23860
Phone (804) 452-3624

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

140 E Ferrell St
South Hill, VA 23970
Phone (434) 447-7375

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1811732217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 PEACHTREE DR",
            "city": "NORTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238607609",
            "telephone_number": "757-528-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W RANDOLPH RD",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602938",
            "telephone_number": "804-641-7404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 E Ferrell St",
            "address_purpose": "LOCATION",
            "city": "South Hill",
            "state": "VA",
            "postal_code": "239702102",
            "country_code": "US",
            "telephone_number": "434-584-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024190276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.