Individual provider Active NPI

Jacqueline Leigh Schenck, PA-C

  • Physician Assistant
  • Winchester, VA
National Provider Identifier
1962894410
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-004842 Issued in VA
Practice address
104 Selma Dr
Winchester, VA 22601-3834
Phone
(540) 678-2800
Fax
(540) 678-2859
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004842 VA Primary

Addresses

Primary practice location

104 Selma Dr
Winchester, VA 22601-3834

Mailing address

104 Selma Dr
Winchester, VA 22601-3834
Phone (540) 678-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150415001596 VA Practitioner - Physician Assistant 2961720370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110-004842VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Regional Enterprises, Inc CurrentSince Aug 22, 2016 Accepting new patients
Valley Regional Enterprises, Inc CurrentSince Aug 22, 2016 Accepting new patients

Locations

607 E Jubal Early Dr
Winchester, VA 22601
Phone (540) 536-2232

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, 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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1962894410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800",
            "fax_number": "540-678-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800",
            "fax_number": "540-678-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENCK",
        "first_name": "JACQUELINE",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.