Mid South Community Pathology

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

1965 Issued in TN

Legal business name

MID SOUTH COMMUNITY PATHOLOGY

Practice address

1805 N Jackson St
Suite 7
Tullahoma, TN 37388-2290

Phone

(931) 461-8871

Fax

(931) 461-8874

NPI assigned

Nov 23, 2009

Organization subpart

Yes

Parent organization

COMMUNITY PATHOLOGY LABORATORYAs reported in NPPES

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

Authorized official

Name

Mr. Mike Thomas Hall

Title

Office Manager

Phone

(931) 528-2836

Specialties & licenses 1

Addresses

Tax ID family

Community Pathology Laboratory LLC2 organizations share this tax ID, including this one

Part of

Community Pathology Laboratory LLC

Other organizations with this tax ID 1

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

• Community Pathology Laboratory LLC

  • Specialist
  • Cookeville, TN
  • NPI 1366440570
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Community Pathology Laboratory LLC

  • Specialist
  • Cookeville, TN
  • NPI 1366440570
  NPPES parent name

Practitioners 1

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

• Meiklejohn Dane McKenzie, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Cookeville, TN
  • NPI 1417167768
  NPD

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1073841573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST",
            "address_2": "SUITE 7",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882290",
            "telephone_number": "931-461-8871",
            "fax_number": "931-461-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST",
            "address_2": "SUITE 7",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882290",
            "telephone_number": "931-461-8871",
            "fax_number": "931-461-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH COMMUNITY PATHOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY PATHOLOGY LABORATORY",
        "enumeration_date": "2009-11-23",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-528-2836",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TN",
            "license": "1965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Imaging Consultants, PC
• Medport, Inc.
• Medworks of Tullahoma PC
• Meredith Schweitzer, D.O., P.C.
• Ashley C Messick-Hite, C-PA
• Middle Tennessee Oral & Maxillofacial Surgery
• William M Milam, M.D.
• Chasity Nicole Miller
• Justin Neal Miller, MD
• Laura M Miller, DPT

• All providers in Tullahoma, TN
• Clinical Pathology/Laboratory Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.