Organization Active NPI

Pleasant Valley Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • PT Pleasant, WV
National Provider Identifier
1124126024
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
15018 Issued in WV
Legal business name
PLEASANT VALLEY PATHOLOGY ASSOCIATES
Practice address
2520 Valley Dr
PT Pleasant, WV 25550-2031
Phone
(304) 675-4340
Fax
(304) 675-1328
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas Eugene Schauer
Title
Chief Financial Officer
Phone
(304) 675-4340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 15018 WV Primary

Addresses

Primary practice location

2520 Valley Dr
PT Pleasant, WV 25550-2031

Mailing address

2520 Valley Dr
PT Pleasant, WV 25550-2031
Phone (304) 675-4340

Other identifiers 2

IdentifierTypeStateIssuer
0672311MedicaidOH
0008613000MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124126024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 VALLEY DR",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "255502031",
            "telephone_number": "304-675-4340",
            "fax_number": "304-675-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 VALLEY DR",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "255502031",
            "telephone_number": "304-675-4340",
            "fax_number": "304-675-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY PATHOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHAUER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "304-675-4340"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WV",
            "license": "15018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672311",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008613000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in PT Pleasant, WV

Sources for this page

  • 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.