NPIMap

Organization Active NPI

North Star Pathology PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Reidsville, NC
National Provider Identifier
1225020944
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
NORTH STAR PATHOLOGY PLLC
Practice address
618 S Main St
Reidsville, NC 27320-5020
Phone
(336) 951-4551
Fax
(336) 951-4909
NPI assigned
Aug 18, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Hugh E Fraser III, MDNPI 1538151196
Title
President
Phone
(336) 951-4551

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

618 S Main St
Reidsville, NC 27320-5020

Mailing address

PO Box 3391
Martinsville, VA 24115-3391
Phone (276) 670-2400

Other identifiers 4

IdentifierTypeStateIssuer
5900080MedicaidNC
CJ7179OtherRAILROAD MEDICARE
0178XOtherNCBCBS OF NC
89011VCMedicaidNC

National Provider Directory

National Provider Directory

Locations

829 S Scales St
Reidsville, NC 27320
Phone (336) 361-0244

Practitioners & affiliated clinicians

Practitioners 5

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": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225020944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3391",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241153391",
            "telephone_number": "276-670-2400",
            "fax_number": "276-670-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205020",
            "telephone_number": "336-951-4551",
            "fax_number": "336-951-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR PATHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "HUGH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-951-4551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900080",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7179",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0178X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011VC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.