Southside Kidney Specialists

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SOUTHSIDE KIDNEY SPECIALISTS

Practice address

3400 S Crater Rd
Ste #B
Petersburg, VA 23805-9252

Phone

(804) 733-6960

Fax

(804) 733-3880

NPI assigned

May 7, 2013

Organization subpart

Yes

Parent organization

SOUTHSIDE KIDNEY SPECIALISTSAs reported in NPPES

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

Authorized official

Name

Vijaya Lakshmi Chirumamilla, MDNPI 1194773994

Title

Owner

Phone

(804) 733-6960

Specialties & licenses 1

Addresses

Tax ID family

Southside Kidney Specialists2 organizations share this tax ID, including this one

Part of

Southside Kidney Specialists

Other organizations with this tax ID 1

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

• Southside Kidney Specialists

  • Nephrology Physician
  • Petersburg, VA
  • NPI 1033130026
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Southside Kidney Specialists

  • Nephrology Physician
  • Petersburg, VA
  • NPI 1033130026
  NPPES parent name

Practitioners 1

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

• Vijaya Lakshmi Chirumamilla, M.D.

  • Nephrology Physician
  • Petersburg, VA
  • NPI 1194773994

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367884800000",
    "number": "1508201385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E. FERRELL ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239702202",
            "telephone_number": "434-447-3455",
            "fax_number": "434-447-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S CRATER RD",
            "address_2": "STE #B",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059252",
            "telephone_number": "804-733-6960",
            "fax_number": "804-733-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE KIDNEY SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE KIDNEY SPECIALISTS",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A",
        "authorized_official_last_name": "CHIRUMAMILLA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_middle_name": "LAKSHMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-733-6960",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southerncare Inc
• Southside Dental Associates PC
• Southside Dental Cares, PC
• Southside Family Practice P.C.
• Southside Kidney Specialists
• Southside OB-GYN, Inc.
• Southside Physicians for Women, LLC
• Southside Specialists for Women, P.C.
• Southside Virginia Emergency Crew,Inc.
• Southside Virginia Training Center

• Nephrology Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Nephrology Physician in Virginia

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