NPIMap

Organization Active NPI

Three Rivers Pathology PA

  • Anatomic Pathology Physician
  • Roseville, MN
National Provider Identifier
1003878661
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
THREE RIVERS PATHOLOGY PA
Practice address
2664 Patton Road
Roseville, MN 55113
Phone
(651) 635-9700
Fax
(651) 635-9026
NPI assigned
Apr 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lars T Conway, MDNPI 1679534432
Title
President
Phone
(651) 635-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X
Anatomic Pathology Physician 207ZP0101X Primary

Addresses

Primary practice location

2664 Patton Road
Roseville, MN 55113

Mailing address

PO Box 1450
N W 5737
Minneapolis, MN 55485-5737
Phone (651) 635-9700

Other identifiers 2

IdentifierTypeStateIssuer
13984THOtherMNBCBS
C03199OtherMNRR MEDICARE

National Provider Directory

National Provider Directory

Locations

2664 Patton Rd
Roseville, MN 55113
Phone (612) 474-8444

3701 12th St N
Saint Cloud, MN 56303
Phone (320) 253-7257

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1003878661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "address_2": "N W 5737",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554855737",
            "telephone_number": "651-635-9700",
            "fax_number": "651-635-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 PATTON ROAD",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-635-9700",
            "fax_number": "651-635-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS PATHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "LARS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-635-9700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13984TH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "C03199",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.