NPIMap

Organization Active NPI

Ocmulgee Medical Pathology Association, Inc

  • Clinical Medical Laboratory
  • Tucker, GA
National Provider Identifier
1356714703
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
11D2101227 Issued in GA
Legal business name
OCMULGEE MEDICAL PATHOLOGY ASSOCIATION, INC
Practice address
1777 Montreal Cir
Ap Suite
Tucker, GA 30084-6802
Phone
(865) 300-6326
NPI assigned
Nov 6, 2015
Last updated
Nov 6, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERIPATH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Authorized official

Name
Dr. Edward Michael Kramer, MD
Title
Vice President
Phone
(610) 550-3003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 11D2101227 GA Primary

Addresses

Primary practice location

1777 Montreal Cir
Ap Suite
Tucker, GA 30084-6802

Mailing address

14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (865) 300-6326

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000673 GA Part B Supplier - Independent Clinical Laboratory 3476466905 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marietta, GA; Tucker, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2221 Newmarket Pkwy SE
Ste 107
Marietta, GA 30067
Phone (770) 612-1395

2275 Northwest Pkwy SE
Ste 140
Marietta, GA 30067
Phone (770) 951-1793

Practitioners & affiliated clinicians

Practitioners 7

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": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1356714703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "865-300-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 MONTREAL CIR",
            "address_2": "AP SUITE",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846802",
            "telephone_number": "865-300-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCMULGEE MEDICAL PATHOLOGY ASSOCIATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH, INC",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-550-3003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D2101227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.