Individual provider Active NPI

Maxwell Louis Hargrove, PA-C

  • Physician Assistant
  • Portsmouth, VA
National Provider Identifier
1861782666
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone
(757) 953-5000
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 Primary

Addresses

Primary practice location

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708

Mailing address

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone (757) 953-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1861782666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "MAXWELL",
        "middle_name": "LOUIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.