Individual provider Active NPI

Jordan Matthew Maddra, PA

  • Physician Assistant
  • Rockingham, VA
National Provider Identifier
1033062500
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011753 Issued in VA
Practice address
2006 Health Campus Dr Ste 200
Rockingham, VA 22801-8679
Phone
(540) 689-5600
Fax
(844) 305-2339
NPI assigned
Feb 16, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110011753 VA Primary

Addresses

Primary practice location

2006 Health Campus Dr Ste 200
Rockingham, VA 22801-8679

Mailing address

2006 Health Campus Dr Ste 200
Rockingham, VA 22801-8679
Phone (540) 689-5600

Other practice location 1

2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone (540) 689-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429002914 VA Practitioner - Physician Assistant 3476020264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Independence Blvd
FL 5
Virginia Beach, VA 23455-6011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110011753VAMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1033062500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HEALTH CAMPUS DR STE 200",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-5600",
            "fax_number": "844-305-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 HEALTH CAMPUS DR STE 200",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-5600",
            "fax_number": "844-305-2339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Health Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "VA",
            "postal_code": "228018679",
            "country_code": "US",
            "telephone_number": "540-689-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDRA",
        "first_name": "JORDAN",
        "middle_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, VA

Sources for this page

Verify at the official NPI Registry.