Individual provider Active NPI

Caitlyn Peribonio, FNP-C

  • Family Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1801514898
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184670 Issued in VA
Practice address
1100 Volvo Pkwy Ste 100
Chesapeake, VA 23320-3341
Phone
(757) 389-5370
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184670 VA Primary

Addresses

Primary practice location

1100 Volvo Pkwy Ste 100
Chesapeake, VA 23320-3341

Mailing address

11761 Rock Landing Dr Ste 8
Newport News, VA 23606-4235
Phone (757) 232-8769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831002104 VA Practitioner - Nurse Practitioner 4789068396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

1100 Volvo Pkwy
Suite 100
Chesapeake, VA 23320-3341
Phone (757) 389-5370

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024184670VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Aug 8, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Aug 8, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Aug 28, 2022 Accepting new patients

Locations

1100 Volvo Pkwy
Ste 100
Chesapeake, VA 23320
Phone (757) 389-5370

827 Diligence Dr
Ste 100
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

11761 Rock Landing Dr
Ste 8
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1801514898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11761 ROCK LANDING DR STE 8",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064235",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VOLVO PKWY STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203341",
            "telephone_number": "757-389-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIBONIO",
        "first_name": "CAITLYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.