Individual provider Active NPI

Addison Leigh Blackwell

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1316807183
Registry record updated Jul 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110012057 Issued in VA
Practice address
825 Fairfax Ave
Norfolk, VA 23507-1912
Phone
(757) 446-5600
NPI assigned
Nov 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 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 0110012057 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Norfolk, VA 23507-1912

Mailing address

825 Fairfax Ave
Norfolk, VA 23507-1912
Phone (757) 446-5600

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3517 Edinburgh Dr
Virginia Beach, VA 23452-4452

4100 International PLZ
Fort Worth, TX 76109-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783209600000",
    "number": "1316807183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071912",
            "telephone_number": "757-446-5600"
        },
        {
            "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": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ADDISON",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-14",
        "last_updated": "2026-07-05",
        "certification_date": "2026-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110012057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.