SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER
NPI 1720462294
Clinic/Center - Federally Qualified Health Center (FQHC) in Suffolk, VA
About Southeastern Virginia Health System At Western Tidewater Community Ser NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER (NPI 1720462294) is a healthcare organization registered as a federally qualified health center (fqhc) in Suffolk, Virginia and active in the NPI registry since July 2015. The organization lists Angela Futrell, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeastern Virginia Health System At Western Tidewater Community Ser is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Southeastern Virginia Health System At Western Tidewater Community Ser, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 7
Clinicians, nearest first (18)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Peninsula Institute For Community Health Inc's NPI number?
The NPI number for Peninsula Institute For Community Health Inc is 1720462294. It was assigned to this organization in the NPPES registry on July 15, 2015. The provider is doing business as Southeastern Virginia Health System At Western Tidewater Community Ser.
Where is Peninsula Institute For Community Health Inc located?
Peninsula Institute For Community Health Inc is located at 5268 Godwin Blvd, Suffolk, VA 23434. The listed phone number is (757) 255-7133.
What is Peninsula Institute For Community Health Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Peninsula Institute For Community Health Inc enrolled in Medicare?
Yes. Peninsula Institute For Community Health Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peninsula Institute For Community Health Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 7 Medicare specialties reassign their Medicare billing to Peninsula Institute For Community Health Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (5), Family Practice (4) and Nurse Practitioner (3). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Peninsula Institute For Community Health Inc was last updated on July 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southeastern Virginia Health System At Western Tidewater Community Ser · NPI 1720462294
Federally Qualified Health Center (FQHC) organization in Suffolk, Virginia. Organization record, active in the CMS NPPES registry since July 15, 2015.
## Identity
- **NPI:** 1720462294 (Entity type: Organization)
- **Enumerated:** July 15, 2015
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Peninsula Institute For Community Health Inc
- **Organization subpart:** No
- **Authorized official:** Angela Futrell, CEO
## Practice location
- **Address:** 5268 GODWIN BLVD, Suffolk, VA 23434-8114
- **Phone:** (757) 255-7133 · **Fax:** (757) 255-7142
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (5), Family Practice (4), Nurse Practitioner (3) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 20, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1720462294) · Data from the CMS NPPES public registry.