NPIMap

Organization Active NPI

Pathway Pediatrics, Inc.

  • Pediatrics Physician
  • Sylacauga, AL
National Provider Identifier
1083014658
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27850 Issued in AL
Legal business name
PATHWAY PEDIATRICS, INC.
Practice address
209 W Spring St
Suite 300
Sylacauga, AL 35150-2973
Phone
(256) 208-0060
Fax
(256) 208-0755
NPI assigned
Sep 2, 2014
Last updated
Sep 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Authorized official

Name
Dr. Leslie Sawyer, M.D.NPI 1912049420
Title
President / Pediatrician
Phone
(256) 208-0060

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
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 27850 AL Primary

Addresses

Primary practice location

209 W Spring St
Suite 300
Sylacauga, AL 35150-2973

Mailing address

209 W Spring St
Suite 300
Sylacauga, AL 35150-2973
Phone (256) 208-0060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180417000677 AL Part A Provider - Rural Health Clinic 5294098620 Practice locations: Sylacauga, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083014658. Details of each certification follow.

Rural health clinic certification: CCN 018933

Legal name
PATHWAY PEDIATRICS INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 9, 2018
Last certification
Jan 28, 2026
Ownership / control type
1C
Organization structure
CorporationProprietary
Incorporated
Aug 29, 2014 in AL
Enrollment address
40920 US Highway 280
Sylacauga, AL 35150-6838

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
01D1071366Pathway Pediatrics Inc40920 US Hwy 280, Sylacauga, AL 35150Certificate of waiverJul 24, 2027

National Provider Directory

National Provider Directory

Locations

398 Chesser Dr
Ste 7
Chelsea, AL 35043

40920 US Highway 280
Sylacauga, AL 35150
Phone (256) 208-0060

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Leslie R Sawyer Individual 5% Or Greater Direct Ownership Interest Aug 29, 2014 51%
Corporate Officer Aug 29, 2014 51%
W-2 Managing EmployeePresident Aug 29, 2014 51%
Operational/Managerial ControlPresident Aug 29, 2014 51%
Megan J Moore Individual 5% Or Greater Direct Ownership Interest Aug 29, 2014 49%
Corporate OfficerVice President Aug 29, 2014 49%
W-2 Managing EmployeeVice President Aug 29, 2014 49%
Operational/Managerial ControlVice President Aug 29, 2014 49%

Practitioners & affiliated clinicians

Practitioners 10

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": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1083014658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W SPRING ST",
            "address_2": "SUITE 300",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502973",
            "telephone_number": "256-208-0060",
            "fax_number": "256-208-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W SPRING ST",
            "address_2": "SUITE 300",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502973",
            "telephone_number": "256-208-0060",
            "fax_number": "256-208-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT / PEDIATRICIAN",
        "authorized_official_telephone_number": "256-208-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "27850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.