Active NPI
Justin J Path, CPT1
- Phlebotomy Technician
- Eureka, CA
National Provider Identifier
1225892292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CPT-02392352
- Practice address
- 1459 Myrtle Ave
Eureka, CA 95501-1304 - Phone
- (707) 442-0881
- Fax
- (707) 442-1084
- NPI assigned
- Feb 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | CPT-02392352 | CA | Primary |
Addresses
Primary practice location
1459 Myrtle Ave
Eureka, CA 95501-1304
Mailing address
1732 Bird Ave
McKinleyville, CA 95519-3881
Phone (530) 738-3474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT-02392352 | CA | MD | Phlebotomy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duncan Chiropractic, Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1225892292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1732 BIRD AVE",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955193881",
"telephone_number": "530-738-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 MYRTLE AVE",
"city": "EUREKA",
"state": "CA",
"postal_code": "955011304",
"telephone_number": "707-442-0881",
"fax_number": "707-442-1084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATH",
"first_name": "JUSTIN",
"middle_name": "J",
"credential": "CPT1",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-09",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CA",
"license": "CPT-02392352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.