NPIMap

Organization Active NPI

WCP Pathology, PC

  • Clinical Medical Laboratory
  • Maryland Heights, MO
National Provider Identifier
1215008396
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WCP PATHOLOGY, PC
Practice address
2326 Millpark Dr
Maryland Heights, MO 63043-3530
Phone
(314) 991-4313
Fax
(314) 991-4317
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Lyttle
Title
Executive Director
Phone
(314) 991-4313

Specialties & licenses 1

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

Addresses

Primary practice location

2326 Millpark Dr
Maryland Heights, MO 63043-3530

Mailing address

2326 Millpark Dr
Maryland Heights, MO 63043-3530
Phone (314) 991-4313

Other identifiers 2

IdentifierTypeStateIssuer
329187OtherMOHEALTHLINK
18086OtherMOHEALTHCARE USA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140116001110 MO Part B Supplier - Clinic/Group Practice 4688802721 Receives reassigned benefits from 5 practitioners
Practice locations: Maryland Heights, MO; Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215008396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 MILLPARK DR",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433530",
            "telephone_number": "314-991-4313",
            "fax_number": "314-991-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 MILLPARK DR",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433530",
            "telephone_number": "314-991-4313",
            "fax_number": "314-991-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WCP PATHOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYTTLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-991-4313"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "329187",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "18086",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.