NPIMap

Organization Active NPI

Watauga Pathology Associates PC

  • Clinical Medical Laboratory
  • Johnson City, TN
National Provider Identifier
1174820971
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WATAUGA PATHOLOGY ASSOCIATES PC
Practice address
1725 W Market St
Johnson City, TN 37604-6020
Phone
(423) 431-1310
Fax
(423) 431-6331
NPI assigned
Feb 15, 2011
Last updated
Feb 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Dr. David Soike, MDNPI 1295700540
Title
President
Phone
(423) 431-1310

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
Clinical Medical Laboratory 291U00000X TN Primary

Addresses

Primary practice location

1725 W Market St
Johnson City, TN 37604-6020

Mailing address

1725 W Market St
Johnson City, TN 37604-6020
Phone (423) 431-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070919000360 TN Part B Supplier - Clinic/Group Practice 4183718380 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Johnson City, TN

Other NPIs on the same Medicare enrollment 1

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

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
44D0923531Watauga Pathology Associates PC1725 West Market Street, Johnson City, TN 37604AccreditationApr 26, 2027

National Provider Directory

National Provider Directory

Locations

1725 W Market St
Johnson City, TN 37604
Phone (423) 431-1310

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1174820971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W MARKET ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046020",
            "telephone_number": "423-431-1310",
            "fax_number": "423-431-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W MARKET ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046020",
            "telephone_number": "423-431-1310",
            "fax_number": "423-431-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATAUGA PATHOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "SOIKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-431-1310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.