NPIMap

Organization Active NPI

The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1114153269
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC
Practice address
4724 N Davis Hwy FL 2
Pensacola, FL 32503-2339
Phone
(850) 438-1154
NPI assigned
Jun 3, 2009
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
North J Davis, MDNPI 1245242700
Title
President
Phone
(850) 438-1154

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 Primary

Addresses

Primary practice location

4724 N Davis Hwy FL 2
Pensacola, FL 32503-2339

Mailing address

PO Box 3093
Boca Raton, FL 33431-0993
Phone (850) 438-1154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091002000593 FL Part B Supplier - Clinic/Group Practice 8123164233 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Bonifay, FL; Crestview, FL; Defuniak Springs, FL; Pensacola, FL
O20091002000652 FL Part B Supplier - Independent Clinical Laboratory 8123164233 Practice locations: Pensacola, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Pathology Group of Northwest Florida PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4724 N Davis Hwy
Fl 2
Pensacola, FL 32503
Phone (850) 438-1154

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1114153269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3093",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334310993",
            "telephone_number": "850-438-1154",
            "fax_number": "850-433-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY FL 2",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-438-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NORTH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-438-1154",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.