Provider Demographics
NPI:1124079116
Name:ORMSMITH, JESSICA L (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:ORMSMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 FOREST AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3784
Mailing Address - Country:US
Mailing Address - Phone:804-353-4000
Mailing Address - Fax:804-213-9783
Practice Address - Street 1:7231 FOREST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3784
Practice Address - Country:US
Practice Address - Phone:804-353-4000
Practice Address - Fax:804-213-9783
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237335207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1124079116Medicaid
VA010316316Medicaid
P00604261Medicare PIN
VAVV2086B - C03895Medicare PIN
VA010316316Medicaid
VAMC10024Medicare PIN
P00377032Medicare PIN