Pensacola Nephrology, PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PENSACOLA NEPHROLOGY, PA

Doing business as

Renalus Center for Kidney Care

Practice address

221 E Redstone Ave
Crestview, FL 32539-5373

Phone

(850) 398-6606

Fax

(850) 398-6424

NPI assigned

May 5, 2006

Last updated

Feb 19, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

PENSACOLA NEPHROLOGY, PAAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Justin Dansby

Title

Cfo

Phone

(850) 444-7000

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Renalus Center for Kidney Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pensacola Nephrology, PA

  dba Renalus Center for Kidney Care

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1518969765

  O20031205000296, O20040429001260

  Same enrollment
• Pensacola Nephrology, PA

  dba Renalus Center for Kidney Care

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1700829728

  O20031205000296

  Same enrollment

Part of

Pensacola Nephrology PA

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Fresenius Vascular Care of Pensacola ASC LLC

  dba Azura Surgery Center Renalus Pensacola

  • Ambulatory Surgical Clinic/Center
  • Pensacola, FL
  • NPI 1881131621

  Member Of

  NPD member
• Fresenius Vascular Care Pensacola LLC

  dba Azura Vascular Care Renalus Pensacola

  • Vascular & Interventional Radiology Physician
  • Pensacola, FL
  • NPI 1285031963

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Humam Humeda, MD

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1376545566
  NPD
• Derek Jimenez, M.D.

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1194846923
  NPD
• Christopher S Reid, MD

  • Nephrology Physician
  • Pensacola, FL
  • NPI 1174525364
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1033167374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11037",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325241037",
            "telephone_number": "850-444-7000",
            "fax_number": "850-444-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E REDSTONE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395373",
            "telephone_number": "850-398-6606",
            "fax_number": "850-398-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA NEPHROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENSACOLA NEPHROLOGY, PA",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "DANSBY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-444-7000"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870503",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870505",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870502",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870506",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870508",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870504",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870507",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renalus Center for Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Patterson
• Haley Rebecca Paulk, PT, DPT
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• Peachy Orchard LLC
• Tonie Lyn Peasley, OTR/L
• Gary Charles Perez, PHYSICIAN ASSISTANT
• Sherry Nicole Perez
• Performance Prosthetics & Orthotics, PL
• Samaria Perkins
• Brittany Perry

• Nephrology Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.