IndividualActive
Jonathan Lively, PA
NPI 1285763391 · Physician Assistant · Norfolk, VA
Provider details
- NPI number
- 1285763391
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0110002350 (VA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
600 Gresham Dr Ste 8630b
Norfolk, VA 23507-1904
Phone: (757) 388-6115
Street-level locationGet directions
Mailing address
600 Gresham Dr Ste 8630b
Norfolk, VA 23507-1904
Additional practice locations (1)
- 111 Michigan Ave NwWashington, DC 20010-2978Phone: (202) 884-5000
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2021-09-21
- Certified
- 2021-09-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.