Old Dominion Pathology Associates, LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

OLD DOMINION PATHOLOGY ASSOCIATES, LLC

Practice address

3289 Woodburn Rd
Ste 220
Annandale, VA 22003-6800

Phone

(703) 698-1080

Fax

(703) 698-1082

NPI assigned

Jun 2, 2010

Last updated

May 1, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barrett Bolton Brown, MDNPI 1497755656

Title

Partner

Phone

(703) 691-1494

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Barrett Bolton Brown, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Annandale, VA
  • NPI 1497755656
  Authorized official Same address or phone

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1134449051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3289 WOODBURN RD",
            "address_2": "STE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036800",
            "telephone_number": "703-698-1080",
            "fax_number": "703-698-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3289 WOODBURN RD",
            "address_2": "STE 220",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036800",
            "telephone_number": "703-698-1080",
            "fax_number": "703-698-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD DOMINION PATHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BARRETT",
        "authorized_official_middle_name": "BOLTON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "703-691-1494",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Annandale, VA
• Providers in Annandale, VA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.