PENINSULA KIDNEY ASSOCIATES PC
NPI 1750436531
Internal Medicine - Nephrology in Hampton, VA

Active since January 24, 2007CLIA Certified · 3 labs
501 BUTLER FARM RD, SUITE I, HAMPTON, VA 23666(757) 251-7469(757) 251-7470 Get Directions Write a Review

NPPES record last updated: June 2, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Peninsula Kidney Associates Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENINSULA KIDNEY ASSOCIATES PC (NPI 1750436531) is a healthcare organization registered as a nephrology in Hampton, Virginia and active in the NPI registry since January 2007. The organization holds 3 active CLIA laboratory certificates and lists Shawana L Davis, Administrator, as its authorized official.

NPPES Registry Identity

NPI1750436531
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NamePENINSULA KIDNEY ASSOCIATES PC
Location Address501 BUTLER FARM RD, SUITE IHampton, VA 23666-1564
Mailing Address501 Butler Farm Rd, Suite IHampton, VA 23666-1777 · (757) 251-7469 · Fax (757) 251-7470
Fax(757) 251-7470
Organization SubpartNo
Authorized OfficialShawana L DavisAdministrator · (757) 251-7469
Enumeration DateJanuary 24, 2007
Last NPPES UpdateJune 2, 2016
✔ NPI 1750436531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
501 BUTLER FARM RD, Hampton, VA 23666

Other Identifiers 2

Medicaid1750436531VA
Medicare PINC08483VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peninsula Kidney Associates Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Peninsula Kidney Associates PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nephrology7
Nurse Practitioner4

Clinicians, nearest first (11)

Nephrology
NPI 1184720823
501 BUTLER FARM RD STE. I
Hampton, VA 23666
(757) 251-7469
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1386886182
501 BUTLER FARM ROAD SUITE I
Hampton, VA 23666
(757) 251-7469
✔ PECOS✔ Accepts MedicareSame address
Nephrology
NPI 1932205739
501 BUTLER FARM RD STE. I
Hampton, VA 23666
(757) 251-7469
✔ PECOS✔ Accepts MedicareSame address
Nephrology
NPI 1679679468
501 BUTLER FARM RD SUITE I
Hampton, VA 23666
(757) 251-7469
✔ PECOSSame address
Nephrology
NPI 1487862082
501 BUTLER FARM RD SUITE I
Hampton, VA 23666
(757) 251-7469
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1073187506
5 W MERCURY BLVD
Hampton, VA 23669
(757) 723-4620
✔ PECOS✔ Accepts Medicare4.7 mi
Nurse Practitioner
NPI 1285126219
155 KINGSLEY LN
Norfolk, VA 23505
(757) 889-5000
✔ PECOS✔ Accepts Medicare13 mi
Nurse Practitioner
NPI 1972194926
205 BULIFANTS BLVD STE A
Williamsburg, VA 23188
(757) 345-5876
✔ PECOS✔ Accepts Medicare26 mi
Nephrology
NPI 1215043377
400 SENTARA CIR STE 305
Williamsburg, VA 23188
(757) 258-2511
✔ PECOS26 mi
Nephrology
NPI 1700093176
200 1ST ST SW
Rochester, MN 55905
(507) 284-2511
✔ PECOS✔ Accepts Medicare970 mi
Nephrology
NPI 1376875641
717 ENCINO PL NE SUITE 26
Albuquerque, NM 87102
(505) 884-4545
✔ PECOS✔ Accepts Medicare1,690 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0704872

Peninsula Kidney Associates · Hampton, VA
Active · expires Apr 29, 2028
CLIA Number49D0704872
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2026
Certificate Expiration DateApril 29, 2028
Laboratory DirectorJoanne B. Siu, MD
Laboratory Phone(757) 251-7469
Laboratory LocationPeninsula Kidney Associates21 Manhattan Square, Suite A, Hampton, VA 23666
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D2034126

Peninsula Kidney Associates · Newport News, VA
Active · expires Dec 15, 2027
CLIA Number49D2034126
Laboratory TypePhysician Office
Certificate Effective DateDecember 16, 2025
Certificate Expiration DateDecember 15, 2027
Laboratory DirectorJoanne Siu
Laboratory Phone(757) 251-7469
Laboratory LocationPeninsula Kidney Associates716 Denbigh Boulevard - Suite A5, Newport News, VA 23608
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D2054099

Peninsula Kidney Associates · Williamsburg, VA
Active · expires Feb 12, 2027
CLIA Number49D2054099
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorShuping Wang
Laboratory Phone(757) 251-7469
Laboratory LocationPeninsula Kidney Associates205 Bulifants Boulevard - Suite A, Williamsburg, VA 23188
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Kidney Associates PC's NPI number?

The NPI number for Peninsula Kidney Associates PC is 1750436531. It was assigned to this organization in the NPPES registry on January 24, 2007.

Where is Peninsula Kidney Associates PC located?

Peninsula Kidney Associates PC is located at 501 Butler Farm Rd Suite I, Hampton, VA 23666. The listed phone number is (757) 251-7469.

What is Peninsula Kidney Associates PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Peninsula Kidney Associates PC enrolled in Medicare?

Yes. Peninsula Kidney Associates PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Peninsula Kidney Associates PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 2 Medicare specialties reassign their Medicare billing to Peninsula Kidney Associates PC. 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 Nephrology (7) and Nurse Practitioner (4). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Peninsula Kidney Associates PC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Peninsula Kidney Associates PC was last updated on June 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.