Peninsula Orthopaedic Group, PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

0101036538 Issued in VA

Legal business name

PENINSULA ORTHOPAEDIC GROUP, PC

Practice address

304 Marcella Rd
Suite B
Hampton, VA 23666-2578

Phone

(757) 864-0840

Fax

(757) 864-0848

NPI assigned

May 25, 2010

Reactivated

Jun 7, 2013

Organization subpart

No

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

Authorized official

Name

Bruce ReidNPI 1780677930

Title

M.D.

Phone

(757) 870-0699

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Tax ID family

Peninsula Orthopaedic Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Peninsula Orthopaedic Group, PC

  • Orthopaedic Surgery Physician
  • Hampton, VA
  • NPI 1609969641
  NPD tax ID

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6016/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Bruce Walter Reid, M.D.

  • Orthopaedic Surgery Physician
  • Hampton, VA
  • NPI 1780677930
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1497074827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "address_2": "SUITE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-864-8040",
            "fax_number": "757-864-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "address_2": "SUITE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-864-0840",
            "fax_number": "757-864-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA ORTHOPAEDIC GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2013-06-07",
        "deactivation_date": "2013-05-28",
        "reactivation_date": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "757-870-0699"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Family Practice
• Peninsula Foot & Ankle Specialists PLC
• Peninsula Institute for Community Health Inc
• Peninsula Kidney Associates PC
• Peninsula Neurosurgical Associates, Inc.
• Peninsula Orthopaedic Group, PC
• Peninsula Outreach Family Counseling LLC
• Peninsula Periodontics and Implants PLLC
• Peninsula Physical Therapy & Associates, Inc
• Peninsula Surgical Associates, Inc.

• Orthopaedic Surgery Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Orthopaedic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.