Jacquelin N Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004730 Issued in VA

Practice address

1529 Huguenot Rd
Midlothian, VA 23113

Phone

(804) 378-7373

NPI assigned

Sep 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John Randolph OB/GYN, LLC 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/610/brand/3/csg/45/fhir/r4
• Direct secure messaging: jacquelin.smith@hca6.eclinicaldirectplus.com

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.

• John Randolph OB/GYN, LLC

  • Obstetrics & Gynecology Physician
  • Richmond, VA
  • NPI 1720117559

  VA

  Medicare reassignment Care Compare group
• Commonwealth Primary Care

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1750571287

  VA

  Medicare reassignment NPD
• New Beginnings OB GYN PC

  • Obstetrics & Gynecology Physician
  • Fredericksburg, VA
  • NPI 1548299324
  NPD
• Complete Care Center for Women, LLC

  • Specialist
  • Richmond, VA
  • NPI 1700916178
  NPD (past)
• Retreat Cardiology LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1073646501
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chippenham & Johnston-Willis Hospitals Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530662400000",
    "number": "1891196325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 E HUNDRED RD",
            "address_2": "SUITE 104",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238363310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 HUGUENOT RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-378-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELIN",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2018-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becky Smith, OTR/L
• Brent Elliot Smith, M.D.
• Colton Wade Smith
• Desiray Smith
• Elisa Brooke Smith
• Kimberly Ashlyn Smith, OTD, OTR/L
• Kirby Smith, PA-C
• Lana Draney Smith, LPC
• Lauren Alexandra Smith, O.D.
• Lucy Lynn Smith, NP

• All providers in Midlothian, VA
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.