Ameripath Indianapolis PC

Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Rolla, MO

NPI 1053102004 · NPPES record last updated May 16, 2025

Key facts

NPI
1053102004
Entity type
Organization (NPI type 2)
Primary specialty
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
Legal business name
AMERIPATH INDIANAPOLIS PC
Practice address
1000 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 458-7050
Fax
(573) 458-8399
NPI assigned
May 16, 2025
Organization subpart
Yes
Parent organization (as reported)
AMERIPATH INC

Authorized official

Name
Robert Quirey, MD
Title
Ao
Phone
(800) 920-9000

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 67

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250715000914 MO Part B Supplier - Clinic/Group Practice 2961475058 Receives reassigned benefits from 2 practitioners
Practice locations: Rolla, MO

National Provider Directory

Tax ID family
Ameripath Indianapolis PC (7 organizations share this tax ID)

Locations

1515 N Madison Ave
Fl 5
Anderson, IN 46011
Phone (800) 890-6220

10767 Illinois St
Ste 2700
Carmel, IN 46032
Phone (317) 528-1626

2560 N Shadeland Ave
Ste A
Indianapolis, IN 46219
Phone (317) 275-8000

7250 Clearvista Dr
Ste 190A
Indianapolis, IN 46256
Phone (317) 275-8111

9700 E 146th St
Ste 100
Noblesville, IN 46060
Phone (317) 621-3500

6700 Steger Dr
Rm 121
Cincinnati, OH 45237
Phone (513) 353-6531

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207ZP0102X Yes

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3661

Other providers in Rolla, MO

All providers in Rolla, MO · Anatomic Pathology & Clinical Pathology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.