NPIMap

Organization Active NPI

Parkway Pathology Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1245206960
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PARKWAY PATHOLOGY GROUP, INC.
Practice address
3015 N. Ballas Road
Department of Pathology
St. Louis, MO 63131-2329
Phone
(630) 581-6523
Fax
(630) 472-9502
NPI assigned
Feb 23, 2006
Last updated
Apr 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Dr. Dale K. Selby, MD
Title
President
Phone
(314) 996-5653

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2002015959 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 33088 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R2A98 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R5909 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2002005137 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 119920 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R8544 MO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

3015 N. Ballas Road
Department of Pathology
St. Louis, MO 63131-2329

Mailing address

3010 Highland Pkwy Ste 325
Downers Grove, IL 60515-5670
Phone (630) 581-6523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040814000088 MO Part B Supplier - Clinic/Group Practice 5496728818 Receives reassigned benefits from 10 practitioners
Practice locations: O Fallon, MO; Saint Louis, MO; St Peters, MO; Sullivan, MO

National Provider Directory

National Provider Directory

Locations

3010 Highland Pkwy
Ste 325
Downers Grove, IL 60515
Phone (630) 581-6503

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 89

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.

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1245206960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 HIGHLAND PKWY STE 325",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155670",
            "telephone_number": "630-581-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N. BALLAS ROAD",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "630-581-6523",
            "fax_number": "630-472-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY PATHOLOGY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "SELBY",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-996-5653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2002015959",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "33088",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "R2A98",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "R5909",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2002005137",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "119920",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "R8544",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.