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Originally part of a World War I-era Army base, the Navy acquired the area that now encompasses Naval Support Activity Hampton Roads in 1941 and 1942 as part of the World War II build-up. Although physically detached, the area became part of Naval Operating Base (NOB) Norfolk (now Naval Station Norfolk).

The area that currently serves as the U.S. Fleet Forces Command Compound north of International Terminals Boulevard was formerly occupied by the World War II-era U.S. Navy Hospital. The original hospital had been located on Block A of NOB Norfolk. However, increased wartime demand prompted the establishment of a new 750-bed facility east of the U.S. Navy Receiving Station on land transferred from the Army in 1940. Construction began in January 1942. Although the two-story buildings were classified as temporary construction, they were characterized by brick veneer exteriors. The hospital complex was based on a standard pavilion-type plan, and was comprised of detached, H-plan wards linked to a central administration building and mess hall by covered corridors.

In April 1948, the U.S. Atlantic Fleet established its shore headquarters at the former U.S. Navy Hospital, and it has remained there since that time. In the early 1950s, the North Atlantic Treaty Organization (NATO) established a new major command, known as Allied Command, Atlantic under the authority of a U.S. four-star admiral. The Commander in Chief, U.S. Atlantic Fleet (CINCLANFLT) was given command responsibilities, and it was co-located with the U.S. Atlantic Fleet and U.S. Atlantic Command at Norfolk.

On May 1, 1977, the Chief of Naval Operations officially directed the establishment of the Atlantic Fleet Headquarters Support Activity and the disestablishment of flag administrative unit, Commander in Chief, US Atlantic fleet, also known as CINCLANTFLT.

The mission of the Atlantic Fleet Headquarters Support Activity was to direct and coordinate the functions of all departments to ensure that administrative, personnel, logistical, maintenance, transportation, supply, and fiscal services are furnished so that the tenant commands may operate with maximum emphasis on their primary mission.

 In 1987, the chain of command was restructured making Headquarters Support Activity an echelon four command under Commander, Naval Base, Norfolk.

In 1999, Headquarters Support Activity was re-designated a major command and dual-hatted with the responsibilities as the Installation Commander for three base installations and as the Program Director for Regional Support Services.

Headquarters Support Activity was disestablished in March 2000 and renamed Naval Support Activity, Norfolk.

 In October 2011, NSA received approval to change its name to reflect the areas that fall under its footprint to Naval Support Activity Hampton Roads.


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