Active NPI
Clinical Colleagues LLC
- Anesthesiology Physician
- Petersburg, VA
National Provider Identifier
1366958274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- CLINICAL COLLEAGUES LLC
- Practice address
- 200 Medical Park Blvd
Petersburg, VA 23805-9274 - Phone
- (804) 765-5000
- NPI assigned
- Dec 15, 2017
- Last updated
- Sep 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kurt Zumwalt
- Title
- Authorized Official
- Phone
- (800) 494-3948
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
200 Medical Park Blvd
Petersburg, VA 23805-9274
Mailing address
PO Box 824246
Philadelphia, PA 19182-4246
Phone (954) 570-0337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200806002392 | FL | Part B Supplier - Clinic/Group Practice | 8729011333 |
Receives reassigned benefits from 7 practitioners Practice locations: Clewiston, FL |
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Clinical Colleagues Inc
- Anesthesiology Physician
- Riverton, WY
- NPI 1134643604
8729011333
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
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.
-
- Anesthesiology Physician
- Gainesville, FL
- NPI 1669545315
-
- Anesthesiology Physician
- Plant City, FL
- NPI 1669572640
-
- Certified Registered Nurse Anesthetist
- Clewiston, FL
- NPI 1831137181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790294400000",
"number": "1366958274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 824246",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191824246",
"telephone_number": "954-570-0337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PARK BLVD",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059274",
"telephone_number": "804-765-5000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINICAL COLLEAGUES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-15",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A",
"authorized_official_last_name": "ZUMWALT",
"authorized_official_first_name": "KURT",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "800-494-3948"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.