NPIMap

Organization Active NPI

Pensacola Nephrology, PA

Doing business as Renalus Center for Kidney Care

  • Nephrology Physician
  • Gulf Breeze, FL
National Provider Identifier
1245273242
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PENSACOLA NEPHROLOGY, PA
Doing business as
Renalus Center for Kidney Care
Practice address
2583 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3043
Phone
(850) 444-7000
Fax
(850) 434-8144
NPI assigned
Jun 14, 2006
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PENSACOLA NEPHROLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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) 444-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

2583 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3043

Mailing address

PO Box 11037
Pensacola, FL 32524-1037
Phone (850) 444-7000

Other identifiers 12

IdentifierTypeStateIssuer
CF9776OtherRR MEDICARE
256870507MedicaidFL
99659OtherFLBCBS OF FLORIDA
0358OtherFLMED3000/HEALTH 1ST NETWOR
256870500MedicaidFL
256870508MedicaidFL
256870501MedicaidFL
256870503MedicaidFL
256870502MedicaidFL
256870505MedicaidFL
256870504MedicaidFL
256870506MedicaidFL

Other names 1

  • Renalus Center for Kidney Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pensacola Nephrology PA15 organizations share this tax ID, including this one
Part of
Pensacola Nephrology PA

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

5401 Corporate Woods Dr
Ste 850
Pensacola, FL 32504
Phone (850) 484-8646

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1245273242",
    "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": "850-434-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2583 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633043",
            "telephone_number": "850-444-7000",
            "fax_number": "850-434-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA NEPHROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENSACOLA NEPHROLOGY, PA",
        "enumeration_date": "2006-06-14",
        "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": "850-444-4700"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF9776",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870507",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "99659",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED3000/HEALTH 1ST NETWOR",
            "identifier": "0358",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870508",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870503",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870502",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870505",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870504",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870506",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renalus Center for Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulf Breeze, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.