NPIMap

Organization Active NPI

Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1225293707
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
VIVID PATHOLOGY PA
Practice address
5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone
(850) 416-6894
Fax
(850) 416-5487
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Authorized official

Name
Dr. Charles E Farmer, MD
Title
President
Phone
(850) 416-6894

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X FL Primary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X FL

Addresses

Primary practice location

5151 N 9TH Ave
Pensacola, FL 32504-8721

Mailing address

5149 N 9TH Ave Ste 122
Pensacola, FL 32504-8779
Phone (850) 416-2469

Other identifiers 1

IdentifierTypeStateIssuer
L9205OtherFLBCBS OF FL

National Provider Directory

National Provider Directory
Tax ID family
Vivid Pathology PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5149 N 9th Ave
Ste 122
Pensacola, FL 32504
Phone (843) 518-2854

Practitioners & affiliated clinicians

Practitioners 11

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": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1225293707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE STE 122",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048779",
            "telephone_number": "850-416-2469",
            "fax_number": "843-664-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-6894",
            "fax_number": "850-416-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID PATHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-416-6894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "L9205",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

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