Provider Demographics
NPI:1881017580
Name:RESS, CHELSEA LAUREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:LAUREN
Last Name:RESS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37 LAYMANTOWN RD
Practice Address - Street 2:
Practice Address - City:TROUTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24175-6635
Practice Address - Country:US
Practice Address - Phone:540-977-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004501363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1881017580OtherCCCP VIRGINIA PREMIER
VA1881017580OtherTRICARE
VA1881017580OtherUMWA
VA1881017580OtherMEDICAID QMB
VA1881017580OtherOPTIMA HEALTH PLAN
VA1881017580OtherIN TOTAL
VA1881017580OtherHUMANA MEDICARE
VA1881017580OtherCOVENTRY/AETNA BETTER HEALTH
VA1881017580OtherMAGELLAN CCP
VA1881017580OtherAETNA
VA1881017580OtherANTHEM MEDIGAP