NPIMap

Organization Active NPI

Wilmington Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Wilmington, NC
National Provider Identifier
1205809589
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
WILMINGTON PATHOLOGY ASSOCIATES PA
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 362-9511
NPI assigned
Feb 8, 2006
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Christopher Dale McKinney, MDNPI 1790773877
Title
President
Phone
(910) 343-7074

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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 20169
Roanoke, VA 24018-0506
Phone (540) 767-2700

Other identifiers 4

IdentifierTypeStateIssuer
8902974MedicaidNC
QPB962MedicaidSC
CI0851OtherRAILROAD MEDICARE
02974OtherNCBCBS OF NC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301001141 NC Part B Supplier - Clinic/Group Practice 2668369075 Receives reassigned benefits from 14 practitioners
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory
Tax ID family
Wilmington Pathology Associates PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

1915 S 17th St
Ste 100
Wilmington, NC 28401
Phone (910) 202-2400

1960 S 17th St
Ste 201
Wilmington, NC 28401
Phone (910) 343-7074

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1205809589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20169",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180506",
            "telephone_number": "540-767-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-362-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON PATHOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-343-7074",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902974",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QPB962",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI0851",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "02974",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.