Individual provider Active NPI

Joseph John, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1790733368
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001755 Issued in VA
Practice address
825 Fairfax Ave
Suite 118
Norfolk, VA 23507-1914
Phone
(757) 446-5955
Fax
(757) 446-5196
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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 023550 NY
Physician Assistant 363A00000X 0110001755 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Suite 118
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5955

Other practice location 1

1060 First Colonial Rd
Virginia Beach, VA 23454-3002
Phone (757) 967-8622

Other practice location 2

2025 Glenn Mitchell Dr
VA Beach, VA 23456-0178
Phone (757) 967-8622

Other practice location 3

200 Ohio St
Medina, NY 14103-1063
Phone (716) 798-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050112000786 VA Practitioner - Physician Assistant 3870559750 Reassigns benefits to 2 organizations
I20190830000916 NY Practitioner - Physician Assistant 3870559750 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023550NYMDPediatric Occupational Therapist
1204TNMDSpeech-Language Pathologist
0110001755VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Aug 15, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2017 Accepting new patients
Bayview Physician Services, PC CurrentSince Aug 15, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2017 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients
Mulbriar Emergency Physicians LLC Physician Assistant Past Accepting new patients
Coastal Podiatry, Inc Past Accepting new patients
North Carolina Em I Medical Services P C Physician Assistant Past Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients
Waterway Emergency Physicians LLC Past Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

1168 First Colonial Rd
Ste 101
Virginia Beach, VA 23454
Phone (757) 481-2515

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1790733368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 118",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 First Colonial Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234543002",
            "country_code": "US",
            "telephone_number": "757-967-8622",
            "fax_number": "757-686-0541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 Glenn Mitchell Dr",
            "address_purpose": "LOCATION",
            "city": "VA Beach",
            "state": "VA",
            "postal_code": "234560178",
            "country_code": "US",
            "telephone_number": "757-967-8622",
            "fax_number": "757-686-0541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Ohio St",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "NY",
            "postal_code": "141031063",
            "country_code": "US",
            "telephone_number": "716-798-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023550",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.