Pensacola Nephrology, PA
Internal Medicine, Nephrology in Niceville, FL. Organization (NPI-2).
NPI number1477501153
StatusActive
Last updated in NPPESFeb 19, 2025
Details
- NPI
- 1477501153
- Entity type
- Organization (NPI-2)
- Legal business name
- Pensacola Nephrology, PA
- Organization subpart
- Yes
- Enumeration date
- May 4, 2006
- Certification date
- Feb 19, 2025
- Last updated
- Feb 19, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | – | – | Yes |
Other names
- Renalus Center For Kidney Care (Doing Business As)
Practice location
4304 Lancaster DrNiceville, FL 32578-4563
Phone 850-862-2385 · Fax 850-862-0482
Mailing address
Po Box 11037Pensacola, FL 32524-1037
Phone 850-444-7000 · Fax 850-444-8144
Authorized official
Justin Dansby
Cfo
8504444700
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