NPIMap

Organization Active NPI

Ell Pathology Lab, LLC

  • Clinical Medical Laboratory
  • Little Rock, AR
National Provider Identifier
1174925382
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ELL PATHOLOGY LAB, LLC
Practice address
10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone
(501) 604-2695
Fax
(501) 604-2699
NPI assigned
Sep 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Dr. Patrick D Walker, M.D.NPI 1750352233
Title
Owner & Director
Phone
(501) 604-2695

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386

Mailing address

10810 Executive Center Dr Ste 101
Little Rock, AR 72211-4386
Phone (501) 604-2695

Other identifiers 2

IdentifierTypeStateIssuer
04D2068199OtherARCLIA
LAP80759OtherARNYSDOH CLINICAL LABORATORY PERMIT

National Provider Directory

National Provider Directory

Locations

10810 Executive Center Dr
Ste 101
Little Rock, AR 72211
Phone 5016042695170

10810 Executive Center Dr
Little Rock, AR 72211
Phone (501) 312-7578

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1174925382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELL PATHOLOGY LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER & DIRECTOR",
        "authorized_official_telephone_number": "501-604-2695",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "04D2068199",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSDOH CLINICAL LABORATORY PERMIT",
            "identifier": "LAP80759",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.