SOUTHSIDE KIDNEY SPECIALISTS
NPI 1033130026
Internal Medicine - Nephrology in Petersburg, VA
NPI Status: Active since July 22, 2006
Contact Information
3400 S CRATER RD
SUITE B
PETERSBURG, VA
ZIP 23805
Phone: (804) 733-6960
Fax: (804) 733-3880
- Organization
- Internal Medicine
- Nephrology
- CLIA Number: 49D1092769
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-02-2026
About SOUTHSIDE KIDNEY SPECIALISTS
This page provides the complete NPI Profile along with additional information for Southside Kidney Specialists, an internist established in Petersburg, Virginia operating as a Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1033130026 assigned on July 2006. The practitioner's primary taxonomy code is 207RN0300X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. Vijaya Lakshmi Chirumamilla M.d. (President)
- NPI
- 1033130026
- Provider Name
- SOUTHSIDE KIDNEY SPECIALISTS
- Entity Type
- Organization
- Location Address
- 3400 S CRATER RD SUITE B PETERSBURG, VA 23805
- Location Phone
- (804) 733-6960
- Location Fax
- (804) 733-3880
- Mailing Address
- 3400 S CRATER RD SUITE B PETERSBURG, VA 23805
- Mailing Phone
- (804) 733-6960
- Mailing Fax
- (804) 733-3880
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-22-2006
- Last Update Date
- 08-22-2020
- Code Navigator
An internist like Southside Kidney Specialists is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 49D1092769
- Facility Type
- Physician Office
- Certificate Effective Date
- December 03, 2024
- Certificate Expiration Date
- December 02, 2026
- Laboratory Director
- DAPHNE BAZILE HARRISON
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Southside Kidney Specialists in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 3 | 3 | 1 | 3 | 0 | 0 | 2 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 6 | 3 | 2 | 3 | 0 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 6 + 3 + 2 + 3 + 0 + 0 + 4 + 24 = 44 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 44 = 6 | 6 | ||||||||
The NPI number 1033130026 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669498390 | MRS. TAMMY FAYE PETERSON Individual | Dietitian, Registered | 3400 S CRATER RD STE.B PETERSBURG, VA 23805 (804) 733-6960 |
| 1710944434 | DR. SUDHAKAR CHANDRAKUMAR RELTON MD Individual | Internal Medicine (Nephrology) | 3400 S CRATER RD PETERSBURG, VA 23805 (804) 733-6960 |
| 1508201385 | SOUTHSIDE KIDNEY SPECIALISTS Organization | Internal Medicine (Nephrology) | 3400 S CRATER RD STE #B PETERSBURG, VA 23805 (804) 733-6960 |
| 1194773994 | DR. VIJAYA LAKSHMI CHIRUMAMILLA M.D. Individual | Internal Medicine (Nephrology) | 3400 S CRATER RD SUITE B PETERSBURG, VA 23805 (804) 733-6960 |
| 1790798379 | LIBERTY DIALYSIS PETERSBURG, LLC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 3400 S CRATER RD PETERSBURG, VA 23805 (804) 732-8228 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033130026, enumerated in the NPI registry as an "organization" on July 22, 2006
The provider is located at 3400 S Crater Rd Suite B Petersburg, Va 23805 and the phone number is (804) 733-6960
This medical organization specializes in Internal Medicine with taxonomy code 207RN0300X with a focus in Nephrology
The provider's CLIA number is 49D1092769 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on July 22, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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