NPIMap

Organization Active NPI

Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1447227590
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME53456 Issued in FL
Legal business name
VIVID PATHOLOGY PA
Practice address
4900 Bayou Blvd Ste 204
Pensacola, FL 32503-2533
Phone
(850) 867-8177
Fax
(850) 876-6727
NPI assigned
Mar 7, 2006
Last updated
Jan 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Dr. Christopher S Dadisman, MDNPI 1447336516
Title
President
Phone
(866) 697-8378

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 65194 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME53456 FL Primary
Clinical Medical Laboratory 291U00000X FL

Addresses

Primary practice location

4900 Bayou Blvd Ste 204
Pensacola, FL 32503-2533

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 3

IdentifierTypeStateIssuer
064208800MedicaidFL
00378OtherFLBCBS
529001600MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116001055 FL Part B Supplier - Independent Clinical Laboratory 9133106784 Practice locations: Pensacola, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Vivid Pathology PA2 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.

Locations

4900 Bayou Blvd
Ste 204
Pensacola, FL 32503
Phone (843) 518-2854

5149 N 9th Ave
Ste 122
Pensacola, FL 32504
Phone (843) 518-2854

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1447227590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BAYOU BLVD STE 204",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032533",
            "telephone_number": "850-867-8177",
            "fax_number": "850-876-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID PATHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "DADISMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-697-8378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "FL",
            "license": "65194",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME53456",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064208800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00378",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529001600",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.