Organization Active NPI

Ameripath Institute of Urological Pathology PC

  • Clinical Medical Laboratory
  • Warren, MI
National Provider Identifier
1225000201
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
23D1024436 Issued in MI
Legal business name
AMERIPATH INSTITUTE OF UROLOGICAL PATHOLOGY PC
Practice address
27472 Schoenherr Rd
Suite 100
Warren, MI 48088-6688
Phone
(586) 774-5819
Fax
(586) 774-5869
NPI assigned
Feb 3, 2006
Reactivated
Mar 19, 2012
Organization subpart
Yes
Parent organization
AMERIPATH INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Mr. Michel H Greene
Title
VP
Phone
(214) 932-8270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 23D1024436 MI Primary

Addresses

Primary practice location

27472 Schoenherr Rd
Suite 100
Warren, MI 48088-6688

Mailing address

7111 Fairway Dr
Suite 400
Palm Beach Gardens, FL 33418-4207
Phone (561) 712-6265

Other identifiers 3

IdentifierTypeStateIssuer
L00236MedicaidSC
4727299MedicaidMI
0E01779OtherMIBC/BS OF MICHIGAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1225000201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 FAIRWAY DR",
            "address_2": "SUITE 400",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334184207",
            "telephone_number": "561-712-6265",
            "fax_number": "561-712-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD",
            "address_2": "SUITE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886688",
            "telephone_number": "586-774-5819",
            "fax_number": "586-774-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIPATH INSTITUTE OF UROLOGICAL PATHOLOGY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC.",
        "enumeration_date": "2006-02-03",
        "last_updated": "2012-03-19",
        "deactivation_date": "2011-01-04",
        "reactivation_date": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "214-932-8270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D1024436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00236",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4727299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MICHIGAN",
            "identifier": "0E01779",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.