Peninsula Cancer Institute, LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

PENINSULA CANCER INSTITUTE, LLC

Practice address

12100 Warwick Blvd.
Suite 201
Newport News, VA 23601-2365

Phone

(757) 534-5555

Fax

(757) 534-5569

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Braden Miller

Title

Cfo

Phone

(757) 594-4006

Specialties & licenses 2

Addresses

Other identifiers 5

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Peninsula Cancer Institute LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Peninsula Cancer Institute LLC

  • Hematology & Oncology Physician
  • Onancock, VA
  • NPI 1710218664
  NPD tax ID
• Riverside Physician Services Inc

  • Cardiovascular Disease Physician
  • Smithfield, VA
  • NPI 1306383781
  NPD tax ID

Locations

Practitioners 2

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

• Anita Kumari

  • Hematology & Oncology Physician
  • Newport News, VA
  • NPI 1518128222
  NPD (past)
• Karla Marie Pray, NP

  • Adult Health Nurse Practitioner
  • Gloucester, VA
  • NPI 1801153531
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1508947342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-594-4006",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 WARWICK BLVD.",
            "address_2": "SUITE 201",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012365",
            "telephone_number": "757-534-5555",
            "fax_number": "757-534-5569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7544 Medical Dr Ste B-1",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "VA",
            "postal_code": "230614299",
            "country_code": "US",
            "telephone_number": "804-693-9037",
            "fax_number": "804-693-9486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Kings Way Ste 3100-A",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231852505",
            "country_code": "US",
            "telephone_number": "757-345-5724",
            "fax_number": "757-345-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENINSULA CANCER INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-594-4006"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101043974",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101047727",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010125626",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010162338",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010202761",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010228484",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pen Transport LLC
• Bayley Pendleton, ATC
• Peninsula Academy for Autism
• Peninsula Agency on Aging
• Peninsula ASC, LLC
• Peninsula Community Solutions
• Peninsula Counseling Center of Virginia, LLC
• Peninsula Dermatology Skin Cancer Surgery Center, Inc
• Peninsula Family Dentistry
• Peninsula Gastroenterology, PC

• Hematology & Oncology Physician in Newport News, VA
• Providers in Newport News, VA by specialty
• Hematology & Oncology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.