NPIMap

Organization Active NPI

S Wilson Diagnostic Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Indiana, PA
National Provider Identifier
1043347297
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
S WILSON DIAGNOSTIC PATHOLOGY LLC
Practice address
835 Hospital Rd
Indiana, PA 15701-3629
Phone
(724) 357-7167
Fax
(724) 357-7481
NPI assigned
Feb 27, 2007
Last updated
Aug 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Dr. Steven Henry Wilson, M.D.NPI 1750454054
Title
President
Phone
(724) 357-7167

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

835 Hospital Rd
Indiana, PA 15701-3629

Mailing address

PO Box 20452
Columbus, OH 43220-0452
Phone (614) 442-2418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070410000421 PA Part B Supplier - Clinic/Group Practice 6204931835 Receives reassigned benefits from 4 practitioners
Practice locations: Indiana, PA; Punxsutawney, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1043347297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20452",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432200452",
            "telephone_number": "614-442-2418",
            "fax_number": "614-583-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 HOSPITAL RD",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013629",
            "telephone_number": "724-357-7167",
            "fax_number": "724-357-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S WILSON DIAGNOSTIC PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-357-7167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.