NPIMap

Organization Active NPI

St Lukes Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Overland Park, KS
National Provider Identifier
1285797571
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
17D1034613 Issued in KS
Legal business name
ST LUKES PATHOLOGY ASSOCIATES PA
Practice address
12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone
(816) 932-3241
NPI assigned
Dec 18, 2006
Organization subpart
Yes
Parent organization
AMERIPATH INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Authorized official

Name
Mr. Michael H Greene
Title
VP
Phone
(214) 932-8270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 17D1034613 KS Primary

Addresses

Primary practice location

12300 Metcalf Ave
Overland Park, KS 66213-1324

Mailing address

7111 Fairway Dr
Suite 400
Palm Beach Gardens, FL 33418-4207
Phone (561) 712-6265

Other identifiers 2

IdentifierTypeStateIssuer
501949507AMedicaidKS
1285797571MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1285797571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 FAIRWAY DR",
            "address_2": "SUITE 400",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334184207",
            "telephone_number": "561-712-6265",
            "fax_number": "561-712-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "816-932-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES PATHOLOGY ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC.",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "214-932-8270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "17D1034613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501949507A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285797571",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.