Individual provider Active NPI

Jennifer M Wohl, PA

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1497718746
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840739 Issued in VA
Practice address
110 Kingsley Lane
Ste 309, Granby Internal Medicine PC
Norfolk, VA 23505
Phone
(757) 889-2006
Fax
(757) 889-6559
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 0110840739 VA Primary

Addresses

Primary practice location

110 Kingsley Lane
Ste 309, Granby Internal Medicine PC
Norfolk, VA 23505

Mailing address

860 Omni Blvd
Ste 303
Newport News, VA 23606-4477
Phone (757) 232-8769

Other identifiers 1

IdentifierTypeStateIssuer
010156629MedicaidVA

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
I20041105000284 VA Practitioner - Physician Assistant 0244293710 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110840739VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Physician Assistant CurrentSince Dec 2, 2025 Accepting new patients
Tidewater Emergency Medical Care, LTD. Past Accepting new patients
Apm Spine and Sports Physicians, P.C. Past Accepting new patients
Tidewater Emergency Medical Care Physician Assistant PastSince Feb 2, 2020 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497718746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "STE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064477",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LANE",
            "address_2": "STE 309, GRANBY INTERNAL MEDICINE PC",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23505",
            "telephone_number": "757-889-2006",
            "fax_number": "757-889-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHL",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010156629",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.