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JAQUALLA SMITH
NPI 1902519978
Physician Assistant in Charleston, WV

Active since January 04, 2023PECOS Enrolled
4407 MACCORKLE AVE SE STE 2, CHARLESTON, WV 25304(304) 925-0392 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 22, 2024, Jan 5, 2023 (2 updates tracked since 2023).

About Jaqualla Smith NPPES

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

JAQUALLA SMITH (NPI 1902519978) is an individual physician assistant in Charleston, West Virginia, licensed in West Virginia (2910) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902519978
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJAQUALLA SMITH
Location Address4407 MACCORKLE AVE SE STE 2Charleston, WV 25304-2541
Mailing Address632 Hal Greer Blvd Apt 3Huntington, WV 25701-2975 · (304) 222-4593
Phone(304) 925-0392
Sole ProprietorNo
Enumeration DateJanuary 4, 2023
Last NPPES UpdateJuly 22, 20242 updates tracked since enumeration
NPPES CertifiedJuly 22, 2024
✔ NPI 1902519978 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 WV · 2910
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.
4407 MACCORKLE AVE SE STE 2, Charleston, WV 25304
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaqualla Smith is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25304 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
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

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

JENNIFER REUTHER
Physician Assistant
4407 MACCORKLE AVE SE STE 2
CHARLESTON, WV 25304
Kanawha County (304) 925-0392

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 Jaqualla Smith's NPI number?

The NPI number for Jaqualla Smith is 1902519978. It was assigned to this individual provider in the NPPES registry on January 4, 2023.

Where is Jaqualla Smith located?

Jaqualla Smith practices at 4407 Maccorkle Ave SE Ste 2, Charleston, WV 25304. The listed phone number is (304) 925-0392.

What is Jaqualla Smith's specialty?

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

Is Jaqualla Smith enrolled in Medicare?

Yes. Jaqualla Smith is registered in the Medicare PECOS enrollment system.

What insurance does Jaqualla Smith accept?

Health plans from CareSource list Jaqualla Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jaqualla Smith was last updated on July 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.