Active NPI
Tanika Janae Keagle, AGPCNP
- Gerontology Nurse Practitioner
- Norfolk, VA
National Provider Identifier
1265249916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 0024191131
- Practice address
- 721 Fairfax Ave
Norfolk, VA 23507-2007 - Phone
- (757) 446-7040
- Fax
- (757) 446-7049
- NPI assigned
- Dec 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 0024191131 | VA | Primary |
Addresses
Primary practice location
721 Fairfax Ave
Norfolk, VA 23507-2007
Mailing address
721 Fairfax Ave FL 4
Norfolk, VA 23507-2007
Phone (757) 446-7040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
721 Fairfax Ave
Norfolk, VA 23507-2007
Phone (757) 446-7040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024191131 | VA | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evms Academic Physicians and Surgeons Health Services Foundation | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Norfolk, VA
- NPI 1003887118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1265249916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 FAIRFAX AVE FL 4",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235072007",
"telephone_number": "757-446-7040",
"fax_number": "757-446-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 FAIRFAX AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235072007",
"telephone_number": "757-446-7040",
"fax_number": "757-446-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEAGLE",
"first_name": "TANIKA",
"middle_name": "JANAE",
"credential": "AGPCNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-16",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "VA",
"license": "0024191131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.