NPIMap

Organization Active NPI

Pathology Associates of Lexington PA

  • Anatomic Pathology & Clinical Pathology Physician
  • West Columbia, SC
National Provider Identifier
1316909518
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
6123 Issued in SC
Legal business name
PATHOLOGY ASSOCIATES OF LEXINGTON PA
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 936-8146
Fax
(803) 936-8916
NPI assigned
Apr 4, 2006
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Dr. Ervin Baxter Shaw, M.D.NPI 1962464636
Title
President
Phone
(803) 791-2410

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 19801 SC
Hematology (Pathology) Physician 207ZH0000X 8992 SC
Neuropathology Physician 207ZN0500X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 6123 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 2375
West Columbia, SC 29171-2375
Phone (803) 936-8146

Other identifiers 1

IdentifierTypeStateIssuer
PA5173MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000259 SC Part B Supplier - Clinic/Group Practice 9537135652 Receives reassigned benefits from 12 practitioners
Practice locations: West Columbia, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1316909518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2375",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291712375",
            "telephone_number": "803-936-8146",
            "fax_number": "803-936-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-936-8146",
            "fax_number": "803-936-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF LEXINGTON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ERVIN",
        "authorized_official_middle_name": "BAXTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-791-2410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "SC",
            "license": "19801",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "SC",
            "license": "8992",
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "6123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA5173",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.