Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonathan Lively, PA

Individual provider Physician Assistant · NPI 1285763391

Jonathan Lively, PA is a Physician Assistant in Norfolk, Virginia. Practices as a sole proprietor and works from 2 locations. Licensed in District of Columbia and Virginia.

Licensed in
DC, VA
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904
Phone: (757) 388-6115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 111 Michigan Ave Nw, Washington, DC 20010-2978 — (202) 884-5000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110002350 (VA)
Physician Assistant Taxonomy 363A00000X · Licence PA030452 (DC)

Record details

NPI number1285763391
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMarch 5, 2007
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021
Mailing address600 Gresham Dr Ste 8630b, Norfolk, VA 23507-1904

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