Jaqualla Smith

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2910 Issued in WV

Practice address

4407 Maccorkle Ave SE Ste 2
Charleston, WV 25304-2541

Phone

(304) 925-0392

NPI assigned

Jan 4, 2023

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 WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmith26498@valleyhealthsystems.direct-ci.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.

• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Point Pleasant, WV
  • NPI 1124323340
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1720333461
  Medicare reassignment NPD
• Valley Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1407466535
  Medicare reassignment NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1144096082
  Medicare reassignment NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Point Pleasant, WV
  • NPI 1912693458
  Medicare reassignment NPD
• Valley Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1215707278
  Medicare reassignment
• Valley Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1366212326
  Medicare reassignment
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1659769776
  Medicare reassignment
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Scott Depot, WV
  • NPI 1700446929
  Medicare reassignment
• Valley Health Systems Inc

  • Clinical Medical Laboratory
  • Huntington, WV
  • NPI 1023083854
  NPD
• Valley Health Systems Inc

  • Obstetrics & Gynecology Physician
  • Huntington, WV
  • NPI 1184699415

  Physician Assistant

  NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1225154206
  NPD

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1902519978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 HAL GREER BLVD APT 3",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012975",
            "telephone_number": "304-222-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 MACCORKLE AVE SE STE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042541",
            "telephone_number": "304-925-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAQUALLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Smith, RN
• Hugh Anthony Smith, M.D.
• Jacquelynn Smith
• James Brandon Smith, M.D.
• James Calvin Smith II
• Jasmin Smith
• Jayda Smith, LPN
• Jennifer M. Smith, M.D.
• Jessica Smith
• Jessica Smith

• Physician Assistant in Charleston, WV
• Providers in Charleston, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.