Individual provider Active NPI

Ilana A Nix, CPNP

  • Pediatric Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1619415866
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024174511 Issued in VA
Practice address
601 Childrens LN
Pediatric Critical Care Unit
Norfolk, VA 23507-1910
Phone
(757) 668-7331
Fax
(757) 668-7537
NPI assigned
Feb 8, 2017
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024174511 VA Primary

Addresses

Primary practice location

601 Childrens LN
Pediatric Critical Care Unit
Norfolk, VA 23507-1910

Mailing address

601 Childrens LN
Pediatric Critical Care Unit
Norfolk, VA 23507-1910
Phone (757) 668-7331

Other practice location 1

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other practice location 2

680 Oyster Point Rd Ste 105
Newport News, VA 23606-4570
Phone (757) 668-4851

Other practice location 3

3960 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23452-2449
Phone (757) 668-4648

Other names 1

  • Ilana A Crockin Former name

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
I20170516000088 VA Practitioner - Nurse Practitioner 1850678111 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024174511VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC CurrentSince Apr 1, 2017 Accepting new patients

Locations

680 Oyster Point Rd
Ste 105
Newport News, VA 23606
Phone (757) 668-4851

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

3960 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23452
Phone (757) 668-4648

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1619415866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "address_2": "PEDIATRIC CRITICAL CARE UNIT",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7331",
            "fax_number": "757-668-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "address_2": "PEDIATRIC CRITICAL CARE UNIT",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7331",
            "fax_number": "757-668-7537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202855",
            "country_code": "US",
            "telephone_number": "757-668-4630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Oyster Point Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064570",
            "country_code": "US",
            "telephone_number": "757-668-4851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3960 Virginia Beach Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234522449",
            "country_code": "US",
            "telephone_number": "757-668-4648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIX",
        "first_name": "ILANA",
        "middle_name": "A",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024174511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILANA",
            "last_name": "CROCKIN",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.