NPIMap

Organization Active NPI

Highlands Pathology Consultants, P.C.

  • Clinical Medical Laboratory
  • Bristol, TN
National Provider Identifier
1063498970
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1956 Issued in TN
Legal business name
HIGHLANDS PATHOLOGY CONSULTANTS, P.C.
Practice address
1 Medical Park Blvd
Bristol, TN 37620
Phone
(423) 844-3220
Fax
(423) 844-3114
NPI assigned
Dec 22, 2005
Last updated
Oct 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
David R. Hudgens, M.D.NPI 1003893850
Title
Medical Director
Phone
(423) 844-3220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 1956 TN
Clinical Medical Laboratory 291U00000X 1956 TN Primary

Addresses

Primary practice location

1 Medical Park Blvd
Bristol, TN 37620

Mailing address

2175 Highway 75
Ste 4
Blountville, TN 37617
Phone (423) 323-5290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401001430 TN Part B Supplier - Clinic/Group Practice 3173515715 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Bristol, TN; Kingsport, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1007975Highlands Pathology Consultants PC1 Medical Park Blvd G50, Bristol, TN 37620AccreditationFeb 9, 2028

National Provider Directory

National Provider Directory

Locations

1 Medical Park Blvd
Ste G50
Bristol, TN 37620
Phone (423) 844-3162

1918 W State St
Bristol, TN 37620
Phone (423) 764-3191

10368 Wallace Alley St
Ste 18
Kingsport, TN 37663

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1063498970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 HIGHWAY 75",
            "address_2": "STE 4",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "37617",
            "telephone_number": "423-323-5290",
            "fax_number": "423-323-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-844-3220",
            "fax_number": "423-844-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLANDS PATHOLOGY CONSULTANTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "HUDGENS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-844-3220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "1956",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "1956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.