Northeast Pathology Associates, PC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

NORTHEAST PATHOLOGY ASSOCIATES, PC

Doing business as

Northeast Iowa Pathology Associates, PC

Practice address

1825 Logan Ave
Waterloo, IA 50703-1916

Phone

(319) 235-3679

Fax

(319) 233-0722

NPI assigned

May 2, 2006

Last updated

Jul 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kent A Nickell, M.D.NPI 1942270004

Title

Owner

Phone

(319) 235-3679

Specialties & licenses 1

Addresses

Other names 1

• Northeast Iowa Pathology Associates, PC Doing business as

Practitioners 1

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.

• Kent A Nickell, M.D.

  • Anatomic Pathology Physician
  • Waterloo, IA
  • NPI 1942270004
  Authorized official Same address or phone

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1336107143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2818",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042818",
            "telephone_number": "319-233-3044",
            "fax_number": "319-233-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3679",
            "fax_number": "319-233-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PATHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "NICKELL",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-235-3679",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Iowa Pathology Associates, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anatomic Pathology & Clinical Pathology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.