Peninsula Plastic Surgery Center

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

PENINSULA PLASTIC SURGERY CENTER

Practice address

324 Monticello Ave
Williamsburg, VA 23185-2834

Phone

(757) 229-5200

Fax

(757) 229-2692

NPI assigned

Jan 11, 2021

Organization subpart

No

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

Authorized official

Name

Mr. John Pitman, MDNPI 1275635229

Title

President

Phone

(757) 229-5200

Specialties & licenses 1

Addresses

Other names 1

• Peninsula Plastic Surgery Center Former legal business name

Electronic endpoints 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John M Pitman III, MD

  • General Practice Physician
  • Williamsburg, VA
  • NPI 1275635229

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1356930788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 MONTICELLO AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852834",
            "telephone_number": "757-229-5200",
            "fax_number": "757-229-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MONTICELLO AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852834",
            "telephone_number": "757-229-5200",
            "fax_number": "757-229-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PLASTIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "PITMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-229-5200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "staff@peninsulaplasticsurgerycenter.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "324 Monticello Ave",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231852834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "staff@peninsulaplasticsurgerycenter.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "324 Monticello Ave",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231852834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Peninsula Plastic Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Bridget Lue Pelkey Taylor, LM, CPM
• James Bowles Pender
• Shane H Peng, M.D.
• Peninsula Anesthesia Consultants LLC
• Peninsula Dermatology Skin Cancer Surgery Center, Inc
• Peninsula Plastic Surgery Center
• Peninsula Plastic Surgery Center-ASC
• Peninsula Psychotherapy Center
• Peninsula Surgery Center II LLC
• Pentus Health Primary Care WB LLC

• Plastic Surgery Physician in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.