Peninsula Pathology Associates of Virginia PLLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0101054006 Issued in VA

Legal business name

PENINSULA PATHOLOGY ASSOCIATES OF VIRGINIA PLLC

Practice address

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Phone

(757) 594-2000

NPI assigned

Nov 11, 2014

Organization subpart

No

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

Authorized official

Name

David M Smith, MD

Title

President

Phone

(757) 594-2867

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1972909497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240191010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PATHOLOGY ASSOCIATES OF VIRGINIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-594-2867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "VA",
            "license": "0101054006",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101054006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peninsula Pharmacy Services LLC

• All providers in Newport News, VA
• Anatomic Pathology & Clinical Pathology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.