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ALICE INNIS PA-C
NPI 1093574626
Physician Assistant in Prince George, VA

Active since March 18, 2024PECOS EnrolledAccepts Medicare Assignment
4710 PUDDLEDOCK RD STE 100, PRINCE GEORGE, VA 23875(804) 732-0095 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Alice Innis Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICE INNIS PA-C (NPI 1093574626) is an individual physician assistant in Prince George, Virginia, licensed in Virginia (0110011449) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS, is affiliated with John Randolph Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1093574626
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALICE INNISCredential: PA-C
Location Address4710 PUDDLEDOCK RD STE 100Prince George, VA 23875-1269
Mailing Address4710 Puddledock Rd Ste 100Prince George, VA 23875-1269
Phone(804) 732-0095
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 18, 2024
Last NPPES UpdateNovember 20, 2025
NPPES CertifiedNovember 20, 2025
✔ NPI 1093574626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in VA · 0110011449
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4710 PUDDLEDOCK RD STE 100, Prince George, VA 23875
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alice Innis Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971098542
PECOS Enrollment IDI20251220000130
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John Randolph Medical Center

Acute Care Hospitals · Hopewell, VA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number490020
Location411 West Randolph RoadHopewell, VA 23860 · Hopewell City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23875 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NEAL A FREED M.D.
Emergency Medicine
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0095
SHANNON SCHILSTRA DPT
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0095
EVELYN ANN KOON DPT
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0095
SUSAN M. POWROZNIK PT, DPT
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0035
MR. SEAMUS LYNCH DPT, CSCS
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 285-2645
YOON KONG DPT
Physical Therapist (Orthopedic)
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0035
MORGAN L COX
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0035
MADISON TOWNSEND
Physical Therapist
4710 PUDDLEDOCK RD STE 100
PRINCE GEORGE, VA 23875
Prince George County (804) 732-0035

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alice Innis's NPI number?

The NPI number for Alice Innis is 1093574626. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Alice Innis located?

Alice Innis practices at 4710 Puddledock Rd Ste 100, Prince George, VA 23875. The listed phone number is (804) 732-0095.

What is Alice Innis's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Alice Innis enrolled in Medicare?

Yes. Alice Innis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Alice Innis affiliated with any hospitals?

According to CMS data, Alice Innis is affiliated with John Randolph Medical Center.

When was this NPI record last updated?

The NPPES record for Alice Innis was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.