NPIMap

Organization Active NPI

Pathology Associates of St. Thomas

  • Anatomic Pathology & Clinical Pathology Physician
  • Nashville, TN
National Provider Identifier
1073585774
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
8814 Issued in TN
Legal business name
PATHOLOGY ASSOCIATES OF ST. THOMAS
Practice address
4220 Harding Rd
Nashville, TN 37205-2005
Phone
(615) 222-6756
Fax
(615) 222-6883
NPI assigned
Feb 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Edward Clayton McDonald, M.D,NPI 1306819834
Title
President
Phone
(615) 222-6756

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 39425 TN
Cytopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZC0500X 8814 TN
Hematology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZH0000X 20647 TN
Medical Microbiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZM0300X 8773 TN
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X 8814 TN Primary

Addresses

Primary practice location

4220 Harding Rd
Nashville, TN 37205-2005

Mailing address

PO Box 30309
Charleston, SC 29417-0309
Phone (843) 554-9300

Other identifiers 1

IdentifierTypeStateIssuer
3701748MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001611 TN Part B Supplier - Clinic/Group Practice 2769462845 Receives reassigned benefits from 12 practitioners
Practice locations: Nashville, TN

National Provider Directory

National Provider Directory

Locations

4220 Harding Pike
Ste 504
Nashville, TN 37205
Phone (615) 298-4100

4230 Harding Pike
Ste 1001
Nashville, TN 37205
Phone (615) 298-4100

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1073585774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 HARDING RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052005",
            "telephone_number": "615-222-6756",
            "fax_number": "615-222-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF ST. THOMAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-222-6756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "TN",
            "license": "39425",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": "TN",
            "license": "8814",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "TN",
            "license": "20647",
            "primary": false
        },
        {
            "code": "207ZM0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Medical Microbiology",
            "state": "TN",
            "license": "8773",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "8814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3701748",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.