Individual provider Active NPI

Robert Phillips Jr.

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1407716442
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110012034 Issued in VA
Practice address
825 Fairfax Ave
Norfolk, VA 23507-1912
Phone
(757) 446-5600
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 0110012034 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

825 Fairfax Ave
Norfolk, VA 23507-1912

Mailing address

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

Other practice location 1

600 Gresham Dr Ste 8600
Norfolk, VA 23507-1904
Phone (757) 388-6005

Other practice location 2

600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904
Phone (757) 388-6115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1407716442",
    "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": [
        {
            "address_1": "600 Gresham Dr Ste 8600",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-6005",
            "fax_number": "757-388-6006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Gresham Dr Ste 8630B",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-6115",
            "fax_number": "757-275-9998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ROBERT",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110012034",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.