Active NPI
Paul V Renda, MD
- Anesthesiology Physician
- Virginia Beach, VA
National Provider Identifier
1710903703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Practice address
- 1060 First Colonial Rd
Virginia Beach, VA 23454-3002 - Phone
- (757) 395-8369
- NPI assigned
- Jul 14, 2006
- Last updated
- Nov 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | VA | Primary |
Addresses
Primary practice location
1060 First Colonial Rd
Virginia Beach, VA 23454-3002
Mailing address
134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0055
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6087361 | Medicaid | VA | |
| 5709121 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101037665 | VA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1710903703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 BUSINESS PARK DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234626523",
"telephone_number": "757-473-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 FIRST COLONIAL RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234543002",
"telephone_number": "757-395-8369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDA",
"first_name": "PAUL",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6087361",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5709121",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.