NPIMap

Organization Active NPI

Mid America Pathology Laboratory LLC

  • Clinical Medical Laboratory
  • Overland Park, KS
National Provider Identifier
1215990148
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MID AMERICA PATHOLOGY LABORATORY LLC
Practice address
7301 College Blvd
Suite 110
Overland Park, KS 66210-1937
Phone
(913) 341-6297
Fax
(913) 341-6299
NPI assigned
Apr 11, 2006
Last updated
Oct 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Dr. Russell Lee Benson, M.D.NPI 1427011998
Title
President
Phone
(913) 341-6297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

7301 College Blvd
Suite 110
Overland Park, KS 66210-1937

Mailing address

PO Box 52990
Greenwood, SC 29649-0048
Phone (864) 223-3600

Other identifiers 4

IdentifierTypeStateIssuer
100364660AMedicaidKS
33818014OtherMOKANSAS CITY BCBS
704970607MedicaidMO
405042OtherKSBCBS

Other names 1

  • Midwest Anatomic Pathology Laboratory LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

10730 Nall Ave
Ste 102
Overland Park, KS 66211
Phone (913) 341-6275

Practitioners & affiliated clinicians

Practitioners 2

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1215990148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52990",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490048",
            "telephone_number": "864-223-3600",
            "fax_number": "864-223-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 COLLEGE BLVD",
            "address_2": "SUITE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101937",
            "telephone_number": "913-341-6297",
            "fax_number": "913-341-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA PATHOLOGY LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-341-6297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100364660A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS CITY BCBS",
            "identifier": "33818014",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "704970607",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "405042",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Anatomic Pathology Laboratory LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.