Organization Active NPI

Interventional Pathology of Ohio LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Kettering, OH
National Provider Identifier
1063870699
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35.089844 Issued in OH
Legal business name
INTERVENTIONAL PATHOLOGY OF OHIO LLC
Practice address
580 Lincoln Park Blvd
344
Kettering, OH 45429-3474
Phone
(937) 825-0274
NPI assigned
Feb 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Benjamin McCalip, MDNPI 1649472663
Title
Owner
Phone
(937) 825-0274

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 35.089844 OH Primary

Addresses

Primary practice location

580 Lincoln Park Blvd
344
Kettering, OH 45429-3474

Mailing address

9834 Business Way
Manassas, VA 20110-4151
Phone (703) 257-1440

Other identifiers 1

IdentifierTypeStateIssuer
2775804MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160425000736 OH Part B Supplier - Clinic/Group Practice 0648579763 Receives reassigned benefits from 2 practitioners
Practice locations: Kettering, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1063870699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9834 BUSINESS WAY",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104151",
            "telephone_number": "703-257-1440",
            "fax_number": "703-257-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 LINCOLN PARK BLVD",
            "address_2": "344",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293474",
            "telephone_number": "937-825-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PATHOLOGY OF OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "MCCALIP",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-825-0274",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35.089844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2775804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.