PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC NPI 1508999293

NPI Information

  • NPI: 1508999293
  • Provider Name: PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: 48TH STREET PHYSICIANS
  • CLIA Number: 49D0230244
  • Address: 4714 MARSHALL AVENUE
    NEWPORT NEWS, VA
    ZIP 23607
  • Phone: (757) 380-8709

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NPI Details

PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC is a federally qualified health center (fqhc) clinic center in Newport News, VA. PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC NPI is 1508999293. The provider is registered as an organization entity type.
The provider Is Doing Business As 48th Street Physicians.

The provider's business location address is:

4714 MARSHALL AVENUE
NEWPORT NEWS, VA
ZIP 23607
Phone: (757) 380-8709
Fax: (757) 928-0902

The provider's authorized official is Angela Futrell .
The authorized official title is Chief Executive Officer and has the following contact phone number (757) 380-8709.

The CLIA number assigned to this NPI record is 49D0230244 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 4/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17687648MEDICAIDVIRGINIA
2C00908MEDICARE PINVIRGINIA
3491818MEDICARE OSCAR/CERTIFICATIONVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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