NPIMap

Organization Active NPI

Pathology Services.Org LLC

  • Clinical Medical Laboratory
  • Manistee, MI
National Provider Identifier
1336255538
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
23D0981736 Issued in MI
Legal business name
PATHOLOGY SERVICES.ORG LLC
Practice address
1465 E Parkdale Ave
Cytopathology/Independent Laboratory
Manistee, MI 49660-0070
Phone
(231) 590-5030
Fax
(231) 889-5969
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Authorized official

Name
Ms. Lisa Worley, CT,ASCP,IAC
Title
Limited Member/Sole Owner
Phone
(231) 590-5030

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pathology TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 246R00000X
Clinical Medical Laboratory 291U00000X 23D0981736 MI Primary

Addresses

Primary practice location

1465 E Parkdale Ave
Cytopathology/Independent Laboratory
Manistee, MI 49660-0070

Mailing address

PO Box 70
Att'N Lisa Worley
Manistee, MI 49660-0070
Phone (231) 590-5030

Other identifiers 3

IdentifierTypeStateIssuer
4280673MedicaidMI
0E11500OtherMIBLUE CROSS BLUE SHIELDPPO
71020000E11500OtherMIBCBS OF MICHIGAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1336255538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "address_2": "ATT'N LISA WORLEY",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496600070",
            "telephone_number": "231-590-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 E PARKDALE AVE",
            "address_2": "CYTOPATHOLOGY/INDEPENDENT LABORATORY",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496600070",
            "telephone_number": "231-590-5030",
            "fax_number": "231-889-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY SERVICES.ORG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "WORLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LIMITED MEMBER/SOLE OWNER",
        "authorized_official_telephone_number": "231-590-5030",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CT,ASCP,IAC"
    },
    "taxonomies": [
        {
            "code": "246R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0981736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4280673",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDPPO",
            "identifier": "0E11500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "71020000E11500",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; 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.