NPIMap

Organization Active NPI

Ameripath Indianapolis PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Rolla, MO
National Provider Identifier
1053102004
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 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
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERIPATH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

4770 Regent Blvd
Irving, TX 75063-2445
Phone (866) 697-8378

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Ameripath Indianapolis PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

13179 Collections Ctr Dr
Chicago, IL 60693

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

1550 E County Line Rd
Ste 100
Indianapolis, IN 46227
Phone (317) 818-1000

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

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

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1053102004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445",
            "telephone_number": "866-697-8378",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-7050",
            "fax_number": "573-458-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIPATH INDIANAPOLIS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC",
        "enumeration_date": "2025-05-16",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "QUIREY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "800-920-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.