NPIMap

Organization Active NPI

Pensacola Nephrology, PA

  • Nephrology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1831901594
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
319 Green Acres Rd Ste 103
Fort Walton Beach, FL 32547-1170
Phone
(850) 862-2385
Fax
(850) 444-7497
NPI assigned
Jan 21, 2025
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) 477-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

319 Green Acres Rd Ste 103
Fort Walton Beach, FL 32547-1170

Mailing address

PO Box 11037
Pensacola, FL 32524-1037
Phone (850) 444-4700

Other names 1

  • Renalus Center for Kidney Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pensacola Nephrology PA15 organizations share this tax ID, including this one
Part of
Pensacola Nephrology PA

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1831901594",
    "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": "850-444-4700",
            "fax_number": "850-444-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 GREEN ACRES RD STE 103",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471170",
            "telephone_number": "850-862-2385",
            "fax_number": "850-444-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA NEPHROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENSACOLA NEPHROLOGY, PA",
        "enumeration_date": "2025-01-21",
        "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": "850-477-4700"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renalus Center for Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renalus Center for Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.