NPIMap

Organization Active NPI

Southcentral Pathology Laboratory, PA

  • Cytopathology Physician
  • Wichita, KS
National Provider Identifier
1326028564
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
Legal business name
SOUTHCENTRAL PATHOLOGY LABORATORY, PA
Practice address
929 N Saint Francis St
Wichita, KS 67214-3821
Phone
(316) 268-5426
Fax
(316) 652-0340
NPI assigned
Jan 21, 2006
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Joel W Alderson, DONPI 1629121686
Title
President
Phone
(800) 288-8325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X Primary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X

Addresses

Primary practice location

929 N Saint Francis St
Wichita, KS 67214-3821

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 3

IdentifierTypeStateIssuer
100212820AMedicaidKS
016357OtherKSBCBS
CP8323OtherKSRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823000571 KS Part B Supplier - Clinic/Group Practice 5799759122 Receives reassigned benefits from 10 practitioners
Practice locations: Wichita, KS; Newton, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1137801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1326028564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SAINT FRANCIS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143821",
            "telephone_number": "316-268-5426",
            "fax_number": "316-652-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL PATHOLOGY LABORATORY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-21",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "ALDERSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-288-8325",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100212820A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016357",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP8323",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.