MEDICARE: LAKISHA ANTOINETTE SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	0002094509	VA
2	343900000X	Non-emergency Medical Transport (VAN)		VA

General Provider Information

NPI Number	:	1972216950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKISHA ANTOINETTE SMITH

Provider Business Mailing Address
First Line	:	4624 PLAYER DR NE
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-5828
Country	:	US
Telephone Number	:	540-915-4576
Fax Number	:

Provider Business Practice Location Address
First Line	:	4624 PLAYER DR NE
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-5828
Country	:	US
Telephone Number	:	540-915-4576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2023
Last Update Date	:	12/13/2025

Similar Medicare Providers

1841150273 — MELISSA HUNT KEE LPC
Practice Location Address:

3005 PETERS CREEK RD NW
ROANOKE, VA
24019-2738

Practice Phone: 540-251-7728
Practice Fax:

1215698113 — HANDS ON PLAY PEDIATRIC THERAPY LLC
Practice Location Address:

1590 BEAUMONT RD
ROANOKE, VA
24019-5405

Practice Phone: 540-251-1888
Practice Fax:

1912909094 — ANN B SOWERS M.D.
Practice Location Address:

70 SUMMERFIELD CT
ROANOKE, VA
24019-4579

Practice Phone: 540-966-6616
Practice Fax:

1013911387 — DONALD MAC SCOTHORN O.D.
Practice Location Address:

70 SUMMERFIELD CT
ROANOKE, VA
24019-4579

Practice Phone: 540-966-6616
Practice Fax:

1245234715 — TIMOTHY R BYRNES MD
Practice Location Address:

5296 PETERS CREEK RD
ROANOKE, VA
24019-3808

Practice Phone: 540-855-5100
Practice Fax:

1316942253 — JOHN L HINES MD
Practice Location Address:

5296 PETERS CREEK RD
ROANOKE, VA
24019-3808

Practice Phone: 540-855-5100
Practice Fax:

Directions to “ LAKISHA ANTOINETTE SMITH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.