NPIMap

Organization Active NPI

Pathology Associates, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Huntsville, AL
National Provider Identifier
1386626083
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGY ASSOCIATES, P.C.
Practice address
2904 Westcorp Blvd SW
Suite 107/108
Huntsville, AL 35805-6437
Phone
(256) 533-1480
NPI assigned
Nov 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
John C Romer, M.D.
Title
Medical Director/Vice-President
Phone
(256) 533-1480

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZC0500X
Dermatopathology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZD0900X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary
Clinical Medical Laboratory 291U00000X L4506 AL
Clinical Medical Laboratory 291U00000X L4545 AL

Addresses

Primary practice location

2904 Westcorp Blvd SW
Suite 107/108
Huntsville, AL 35805-6437

Mailing address

2904 Westcorp Blvd SW
Suite 108
Huntsville, AL 35805-6437
Phone (256) 533-1480

Other identifiers 4

IdentifierTypeStateIssuer
51054163OtherALBCBS
C500OtherALBCBS
529502210MedicaidAL
530700103MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000677 AL Part B Supplier - Clinic/Group Practice 1052396249 Receives reassigned benefits from 13 practitioners
Practice locations: Scottsboro, AL; Madison, AL; Huntsville, AL; Athens, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0668455Pathology Associates PC2904 Westcorp Boulevard Suite 107/108, Huntsville, AL 35805AccreditationNov 16, 2027

National Provider Directory

National Provider Directory

Locations

2904 Westcorp Blvd SW
Ste 108
Huntsville, AL 35805
Phone (256) 533-1480

2904 Westcorp Blvd SW
#107108
Huntsville, AL 35805
Phone (256) 253-0624

803 Franklin St SE
Huntsville, AL 35801
Phone (256) 533-1480

2904 Westcorp Blvd SW
Ste 107108
Huntsville, AL 35805
Phone (256) 253-0624

460 Lanier Rd
Ste 202
Madison, AL 35758
Phone (256) 533-1480

8375A Highway 72 W
Madison, AL 35758
Phone (256) 533-1480

380 Woods Cove Rd
Scottsboro, AL 35768
Phone (256) 218-3579

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1386626083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 WESTCORP BLVD SW",
            "address_2": "SUITE 108",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358056437",
            "telephone_number": "256-533-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 WESTCORP BLVD SW",
            "address_2": "SUITE 107/108",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358056437",
            "telephone_number": "256-533-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "ROMER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/VICE-PRESIDENT",
        "authorized_official_telephone_number": "256-533-1480",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AL",
            "license": "L4506",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AL",
            "license": "L4545",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51054163",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "C500",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529502210",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530700103",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.