NPIMap

Organization Active NPI

Boyce - Bynum Pathology Laboratories, Inc

  • Clinical Medical Laboratory
  • Columbia, MO
National Provider Identifier
1205896594
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
26D0652373 Issued in MO
Legal business name
BOYCE - BYNUM PATHOLOGY LABORATORIES, INC
Practice address
200 Portland St
Columbia, MO 65201
Phone
(573) 886-4600
Fax
(573) 886-4695
NPI assigned
Mar 23, 2006
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Richard E Cotten
Title
Chief Operating Officer
Phone
(573) 886-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 26D0652373 MO Primary

Addresses

Primary practice location

200 Portland St
Columbia, MO 65201

Mailing address

200 Portland St
Columbia, MO 65201-6525
Phone (573) 886-4600

Other identifiers 13

IdentifierTypeStateIssuer
20030120AMedicaidOK
700595812OtherMISSOURI CARE
8156825MedicaidMS
36079966MedicaidIL
6593789800MedicaidKY
126758709MedicaidAR
100455390BMedicaidKS
300000488MedicaidIN
888497OtherMERCY CAREPLUS
2194119MedicaidLA
120064OtherBLUE CROSS BLUE SHIELD
275331MedicaidOH
700595812MedicaidMO

National Provider Directory

National Provider Directory

Locations

200 Portland St
Columbia, MO 65201
Phone (573) 886-4600

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": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1205896594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PORTLAND ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016525",
            "telephone_number": "573-886-4600",
            "fax_number": "573-886-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PORTLAND ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-886-4600",
            "fax_number": "573-886-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYCE - BYNUM PATHOLOGY LABORATORIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "COTTEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "573-886-4600"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": "26D0652373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20030120A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI CARE",
            "identifier": "700595812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8156825",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36079966",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6593789800",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126758709",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100455390B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300000488",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CAREPLUS",
            "identifier": "888497",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2194119",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "120064",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275331",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700595812",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.