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) 870-0699

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Walter Reid, M.D.NPI 1780677930

Title

President

Phone

(757) 870-0699

Specialties & licenses 1

Addresses

Other identifiers 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 1497074827
  NPD tax ID

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
  NPD Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377302400000",
    "number": "1609969641",
    "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": "757-870-0699"
        },
        {
            "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": "757-870-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA ORTHOPAEDIC GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-08-24",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-870-0699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "256737",
            "identifier": "ANTHEM",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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.
• Peninsula Vascular Center, P.C.

• 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 Aug 24, 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.