NPIMap

Organization Active NPI

Physician Laboratory Consultants LLC

  • Clinical Medical Laboratory
  • Thomasville, GA
National Provider Identifier
1063840429
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PHYSICIAN LABORATORY CONSULTANTS LLC
Practice address
130 N Broad St
Thomasville, GA 31792-8132
Phone
(800) 899-5757
NPI assigned
Oct 23, 2013
Last updated
Jul 11, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PATHOLOGY ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Authorized official

Name
Janet Tanner
Title
Credentialing
Phone
(229) 228-6496

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

130 N Broad St
Thomasville, GA 31792-8132

Mailing address

PO Box 78545
Saint Louis, MO 63178-8545
Phone (800) 899-5757

Other identifiers 1

IdentifierTypeStateIssuer
300030489AMedicaidGA

National Provider Directory

National Provider Directory
Part of
Pathology Associates PC

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1063840429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78545",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631788545",
            "telephone_number": "800-899-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928132",
            "telephone_number": "800-899-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN LABORATORY CONSULTANTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHOLOGY ASSOCIATES, PC",
        "enumeration_date": "2013-10-23",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "229-228-6496"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030489A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.