It was at that time, that the Atlantic Fleet Commander would create the CINCLANTFLEET Flag Administrative Unit to provide limited logistic services and support to CINCLANTFLT staff's.

In May 1977, after a four-month study, the Chief of Naval Operations established the Atlantic Fleet Headquarters Support Activity (HSA) to provide administrative, personnel, logistics, maintenance, transportation, special services, supply, and fiscal services to tenant activities and commands so they could operate with maximum emphasis on their primary missions.

In October 2011, NSA received approval to change its name to Naval Support Activity Hampton Roads, as it now included two additional bases that were not located in Norfolk.

The hospital's buildings are registered National Register of Historic Places In 2011, the Chief of Naval Operations directed the Bureau of Medicine and Surgery (BUMED) to transfer control of the base to CNIC, which subsequently assigned it to Navy Region Mid-Atlantic and to NSA Hampton Roads.

Naval Support Activity Northwest Annex is located in rural southern Chesapeake, Virginia on the border of North Carolina.

Outside of the Brig, NSA Northwest Annex is the home to several Naval Security Forces related training schools.