Peninsula Kidney Associates PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PENINSULA KIDNEY ASSOCIATES PC

Practice address

501 Butler Farm Rd
Suite I
Hampton, VA 23666-1564

Phone

(757) 251-7469

Fax

(757) 251-7470

NPI assigned

Jan 24, 2007

Last updated

Jun 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shawana L Davis

Title

Administrator

Phone

(757) 251-7469

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 17

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.

• Olayiwola B Ayodeji, M.D, MPH

  • Nephrology Physician
  • Hampton, VA
  • NPI 1932205739
  Medicare reassignment Care Compare group NPD
• Yolanda Brooks, NP

  • Nurse Practitioner
  • Norfolk, VA
  • NPI 1285126219
  Medicare reassignment Care Compare group NPD
• Kanda B Giles, NP-C

  • Family Nurse Practitioner
  • Hampton, VA
  • NPI 1073187506
  Medicare reassignment Care Compare group NPD
• Hoang-Hai Ngoc Nguyen, MD

  • Nephrology Physician
  • Hampton, VA
  • NPI 1487862082
  Medicare reassignment Care Compare group NPD
• Joanne C Siu-Post, MD

  • Nephrology Physician
  • Hampton, VA
  • NPI 1184720823
  Medicare reassignment Care Compare group NPD
• Daniel Lynn Stephenson, FNP-C

  • Nurse Practitioner
  • Williamsburg, VA
  • NPI 1972194926
  Medicare reassignment Care Compare group NPD
• Lei Chen, M.D.

  • Nephrology Physician
  • Albuquerque, NM
  • NPI 1376875641

  VA

  Medicare reassignment Care Compare group NPD
• Merfake Semret, M.D.

  • Nephrology Physician
  • Rochester, MN
  • NPI 1700093176

  VA

  Medicare reassignment Care Compare group NPD
• Thomas M Beazlie, M.D.

  • Nephrology Physician
  • Hampton, VA
  • NPI 1679679468
  Medicare reassignment NPD
• Linda Michelle Jones-Brandon, N.P.

  • Family Nurse Practitioner
  • Hampton, VA
  • NPI 1386886182
  Medicare reassignment NPD
• Shuping Wang, M.D.

  • Nephrology Physician
  • Williamsburg, VA
  • NPI 1215043377
  Medicare reassignment
• Khalil B Dahdah, MD

  • Nephrology Physician
  • Hampton, VA
  • NPI 1447356241
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1750436531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BUTLER FARM RD",
            "address_2": "SUITE I",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661777",
            "telephone_number": "757-251-7469",
            "fax_number": "757-251-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BUTLER FARM RD",
            "address_2": "SUITE I",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661564",
            "telephone_number": "757-251-7469",
            "fax_number": "757-251-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA KIDNEY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHAWANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-251-7469"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750436531",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peninsula Child & Family Services LLC
• Peninsula Cosmetic & Reconstructive Surgery Inc
• Peninsula Family Practice
• Peninsula Foot & Ankle Specialists PLC
• Peninsula Institute for Community Health Inc (Hampton Newport News Community Services Board)
• Peninsula Neurosurgical Associates, Inc.
• Peninsula Orthopaedic Group, PC
• Peninsula Orthopaedic Group, PC
• Peninsula Outreach Family Counseling LLC
• Peninsula Periodontics and Implants PLLC (Atlantic Periodontics & Implants)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.