Mid-Atlantic Pathology Services, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

49D0898222 Issued in VA

Legal business name

MID-ATLANTIC PATHOLOGY SERVICES, INC.

Practice address

1171 Windrock Dr
MC Lean, VA 22102-1547

Phone

(703) 404-8189

Fax

(703) 404-1131

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dina Valladares

Title

Senior Director

Phone

(954) 803-9405

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in DC, NC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 29

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

• Jennifer M Reese, MD

  • Dermatopathology (Pathology) Physician
  • Sterling, VA
  • NPI 1326246927
  NPD
• Jerald F Wolford, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Paris, VA
  • NPI 1801896428
  NPD
• Dawn Lain Butler, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Greensboro, NC
  • NPI 1437440724
  NPD
• Anna Marie Lao Carley, MD

  • Anatomic Pathology Physician
  • Burlington, MA
  • NPI 1487795860

  Anatomic Pathology & Clinical Pathology

  NPD
• Misti Marie Coronel, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Burlington, MA
  • NPI 1124345657
  NPD
• Natalie D. Depcik-Smith, M.D.

  • Specialist
  • Greensboro, NC
  • NPI 1750376067
  NPD
• Mary E Georoff, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Greensboro, NC
  • NPI 1528046562
  NPD
• Paul B Googe, MD

  • Dermatopathology (Pathology) Physician
  • Knoxville, TN
  • NPI 1194789271
  NPD
• Heath Michael Jones, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Burlington, NC
  • NPI 1629211198
  NPD
• Mark Saunders Jordan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Eden, NC
  • NPI 1902901937
  NPD
• Archana Prasad Kanteti, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Maywood, IL
  • NPI 1205320892
  NPD
• Nilesh Digvijay Kashikar, MD PHD

  • Anatomic Pathology Physician
  • Greensboro, NC
  • NPI 1669799276

  Anatomic Pathology & Clinical Pathology

  NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1245302009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915",
            "telephone_number": "214-638-2000",
            "fax_number": "844-751-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 WINDROCK DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221021547",
            "telephone_number": "703-404-8189",
            "fax_number": "703-404-1131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2126 Haycock Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220431717",
            "country_code": "US",
            "telephone_number": "703-404-8189",
            "fax_number": "703-404-1131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MID-ATLANTIC PATHOLOGY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "954-803-9405"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "49D0898222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS DC",
            "identifier": "B020",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4109007 00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006601812",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "200330",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST NATIONAL ACCTS",
            "identifier": "6902000000KU90",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MARYLAND",
            "identifier": "KU90MI",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTHCARE",
            "identifier": "137554",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006601839",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690007157",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gail Metzger, DNP,RN,CPNP-PC,PMHS
• Audrey D Meza Amundaray, CSAC-S
• MGMC, LLC
• Michael J. Ternisky
• Mid-Atlantic Pathology Services, Inc
• Mid-Atlantic Pathology Services, Inc.
• Jacqueline Ann Mielke
• Lacara Miles-Chandler
• Anna Miller
• Caitlin Miller

• Clinical Medical Laboratory in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.