NPIMap

Organization Active NPI

Rex Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Raleigh, NC
National Provider Identifier
1255307187
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20650 Issued in NC
Legal business name
REX PATHOLOGY ASSOCIATES PA
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3040
Fax
(919) 784-3362
NPI assigned
Feb 28, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Dr. Stephen V Chiavetta, MDNPI 1861468779
Title
President
Phone
(919) 784-3040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 31052 NC
Hematology (Pathology) Physician 207ZH0000X 20650 NC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20650 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

PO Box 100559
Florence, SC 29501-0559
Phone (843) 664-4300

Other identifiers 2

IdentifierTypeStateIssuer
0113COtherNCBCBS
890113CMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070313000380 NC Part B Supplier - Clinic/Group Practice 1355444381 Receives reassigned benefits from 10 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1255307187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100559",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010559",
            "telephone_number": "843-664-4300",
            "fax_number": "843-664-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3040",
            "fax_number": "919-784-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX PATHOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "CHIAVETTA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-784-3040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NC",
            "license": "31052",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "NC",
            "license": "20650",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "20650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0113C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890113C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.