Individual provider Active NPI

Grace Anne Jordan, PA

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1437322047
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002802 Issued in VA
Practice address
301 Riverview Ave Ste 202a
Norfolk, VA 23510-1065
Phone
(757) 252-9015
Fax
(757) 510-9041
NPI assigned
Apr 4, 2008
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 NU
Physician Assistant 363A00000X 0110002802 VA Primary

Addresses

Primary practice location

301 Riverview Ave Ste 202a
Norfolk, VA 23510-1065

Mailing address

301 Riverview Ave Ste 202a
Norfolk, VA 23510-1065
Phone (757) 252-9015

Other practice location 1

850 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-5946

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
I20080912000344 VA Practitioner - Physician Assistant 4284700485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

301 Riverview Ave
Norfolk, VA 23510-1065

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002802VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Aug 4, 2008 Accepting new patients

Locations

301 Riverview Ave
Ste 202A
Norfolk, VA 23510
Phone (757) 252-9015

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Interoperability endpoints

  • Direct secure messaging: gjordan12688@direct.sentara.net

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1437322047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 202A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-252-9015",
            "fax_number": "757-510-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 202A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-252-9015",
            "fax_number": "757-510-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Kempsville Rd",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235023920",
            "country_code": "US",
            "telephone_number": "757-261-5946",
            "fax_number": "757-261-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "GRACE",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.