NPIMap

Organization Active NPI

Pensacola Nephrology, PA

Doing business as Renalus Center for Kidney Care

  • Nephrology Physician
  • Pensacola, FL
National Provider Identifier
1700829728
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PENSACOLA NEPHROLOGY, PA
Doing business as
Renalus Center for Kidney Care
Practice address
2940 N Blue Angel Pkwy
Pensacola, FL 32506-2925
Phone
(850) 444-4700
Fax
(850) 434-8144
NPI assigned
Jun 14, 2006
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PENSACOLA NEPHROLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Justin Dansby
Title
Cfo
Phone
(850) 444-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

2940 N Blue Angel Pkwy
Pensacola, FL 32506-2925

Mailing address

PO Box 11037
Pensacola, FL 32524-1037
Phone (850) 444-7000

Other identifiers 2

IdentifierTypeStateIssuer
CF9776OtherFLRR MEDICARE
256870500MedicaidFL

Other names 1

  • Renalus Center for Kidney Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000296 AL Part B Supplier - Clinic/Group Practice 7214832856 Receives reassigned benefits from 25 practitioners
2 other NPIs on this enrollment
Practice locations: Andalusia, AL; Atmore, AL; Brewton, AL; Evergreen, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Pensacola Nephrology PA

Locations

403 W Bypass
Andalusia, AL 36420
Phone (334) 222-0416

1205 Belleville Ave
Brewton, AL 36426
Phone (251) 867-3606

1701 N McKenzie St
Foley, AL 36535
Phone (251) 434-1862

36474A Emerald Coast Pkwy
Ste 1102
Destin, FL 32541

319 Green Acres Rd
#103
Fort Walton Beach, FL 32547

7000 Cobble Crk
Ste 2
Pensacola, FL 32504
Phone (850) 473-4800

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1700829728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11037",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325241037",
            "telephone_number": "850-444-7000",
            "fax_number": "850-444-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N BLUE ANGEL PKWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325062925",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA NEPHROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENSACOLA NEPHROLOGY, PA",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "DANSBY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-444-4700"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF9776",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256870500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renalus Center for Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.