Phillip J States Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MD423371 Issued in PA

Legal business name

PHILLIP J STATES LAB

Practice address

1464 N Main St Ste 5
Punxsutawney, PA 15767-2609

Phone

(814) 938-3550

Fax

(814) 938-3679

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Phillip J States, MD

Title

Owner

Phone

(814) 938-3550

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Phillip J States Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phillip States, MD, Family Practice

  • Rural Health Clinic/Center
  • Punxsutawney, PA
  • NPI 1376865816
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles M Crispino, MD

  • Cardiovascular Disease Physician
  • Pittsburgh, PA
  • NPI 1578560819
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1376733584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 N MAIN ST STE 5",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672609",
            "telephone_number": "814-938-3550",
            "fax_number": "814-938-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 N MAIN ST STE 5",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672609",
            "telephone_number": "814-938-3550",
            "fax_number": "814-938-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP J STATES LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "STATES",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-938-3550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "MD423371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019257860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Irene Parise
• Heather M Park, PA-C
• Ashley N Parsons, CRNP
• William Jason Pearce Jr.
• Penn Neuromuscular Diagnostics, LLC (PNDx)
• Phillip States, MD, Family Practice
• Cameron B Pierce, DPT
• Nicole Leigh Pomeroy I, NP-C
• Patrick Pomeroy, CRNP
• Joseph Presloid, RPH

• Clinical Medical Laboratory in Punxsutawney, PA
• Providers in Punxsutawney, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.