Active NPI
Memory Alexandra Basile
- Physician Assistant
- Norfolk, VA
National Provider Identifier
1942913074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 825 Fairfax Ave
Norfolk, VA 23507-1912 - Phone
- (757) 446-5600
- NPI assigned
- Jan 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
825 Fairfax Ave
Norfolk, VA 23507-1912
Mailing address
825 Fairfax Ave
Norfolk, VA 23507-1912
Other practice location 1
6611 Clyo Rd Ste A
Centerville, OH 45459-2785
Phone (937) 208-7330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3170 Kettering Blvd
Moraine, OH 45439-1924
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Medical Center Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Moraine, OH
- NPI 1659504785
-
- Pediatrics Physician
- Middletown, OH
- NPI 1093919177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776643200000",
"number": "1942913074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071912",
"telephone_number": "757-446-5600"
}
],
"practiceLocations": [
{
"address_1": "6611 Clyo Rd Ste A",
"address_purpose": "LOCATION",
"city": "Centerville",
"state": "OH",
"postal_code": "454592785",
"country_code": "US",
"telephone_number": "937-208-7330",
"fax_number": "937-208-7320",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASILE",
"first_name": "MEMORY",
"middle_name": "ALEXANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-04",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.