Individual provider Active NPI

Madeline Crockett Hanks

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1154130383
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011096 Issued in VA
Practice address
825 Fairfax Ave
Norfolk, VA 23507-1912
Phone
(757) 446-5600
NPI assigned
Jan 2, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110011096 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

825 Fairfax Ave
Norfolk, VA 23507-1912

Mailing address

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other practice location 1

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other practice location 2

3960 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23452-2449
Phone (757) 668-4648

Other practice location 3

680 Oyster Point Rd Ste 105
Newport News, VA 23606-4570
Phone (757) 668-4851

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
I20260415001518 VA Practitioner - Physician Assistant 5092281311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 Childre's LN
Norfolk, VA 23507-1910

601 Childrens LN
Norfolk, VA 23507-1971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110011096VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital of the Kings Daughters Inc Past Accepting new patients

Organizations & group practices 2

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": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1154130383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 VOLVO PKWY",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202855",
            "telephone_number": "757-668-4630",
            "fax_number": "757-668-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071912",
            "telephone_number": "757-446-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202855",
            "country_code": "US",
            "telephone_number": "757-668-4630",
            "fax_number": "757-668-4635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3960 Virginia Beach Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234522449",
            "country_code": "US",
            "telephone_number": "757-668-4648",
            "fax_number": "757-668-4646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Oyster Point Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064570",
            "country_code": "US",
            "telephone_number": "757-668-4851",
            "fax_number": "757-668-4897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANKS",
        "first_name": "MADELINE",
        "middle_name": "CROCKETT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011096",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.