NPIMap

Organization Active NPI

Cedar Valley Pathologists PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1407870058
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
CEDAR VALLEY PATHOLOGISTS PC
Practice address
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Phone
(319) 369-7002
Fax
(302) 416-6097
NPI assigned
Jul 27, 2006
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Thomas J BollingerNPI 1073764627
Title
Treasurer
Phone
(319) 369-7002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X Primary

Addresses

Primary practice location

1026 A Ave NE
Cedar Rapids, IA 52402-5036

Mailing address

PO Box 957076
Saint Louis, MO 63195-7076
Phone (407) 422-9831

Other identifiers 1

IdentifierTypeStateIssuer
0090449MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001864 IA Part B Supplier - Clinic/Group Practice 5698666014 Receives reassigned benefits from 9 practitioners
Practice locations: Grundy Center, IA; Waverly, IA; Waterloo, IA; Sumner, IA; Marshalltown, IA; Dubuque, IA; Cedar Rapids, IA; Anamosa, IA…

National Provider Directory

National Provider Directory

Locations

202 10th St SE
Ste 265
Cedar Rapids, IA 52403
Phone (319) 369-7216

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1407870058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957076",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631957076",
            "telephone_number": "407-422-9831",
            "fax_number": "302-416-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "319-369-7002",
            "fax_number": "302-416-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR VALLEY PATHOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "BOLLINGER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "319-369-7002"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090449",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.