C-S and J Pathology Medical Group, Inc.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

C-S AND J PATHOLOGY MEDICAL GROUP, INC.

Practice address

2170 South Ave
Barton Memorial Hospital-Pathology
South Lake Tahoe, CA 96150-7026

Phone

(530) 542-3000

Fax

(530) 543-0124

NPI assigned

Oct 16, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Mindy Ellen Cooper-Smith, M.D.

Title

President

Phone

(805) 652-1516

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1129420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114916855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 LINCOLN DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012322",
            "telephone_number": "805-652-1516",
            "fax_number": "805-652-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "address_2": "BARTON MEMORIAL HOSPITAL-PATHOLOGY",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-542-3000",
            "fax_number": "530-543-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C-S AND J PATHOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER-SMITH",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-652-1516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0016260",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088350",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susanne Hayes Bull, SLP
• Milagros Buraschi Zapiola
• Gregory Paul Burkard Jr., DO
• Holly Anne Burnam
• Amanda L Bybee-Ramos
• Jordan Cabrera
• Melissa Cahill, CPT
• Monica Barson Campbell, MFC
• Garnet Carlson, RPH
• Dennis Carmona, MFT

• Anatomic Pathology & Clinical Pathology Physician in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.