Organization Active NPI

Heartland Pathology Consultants, PC

  • Anatomic Pathology Physician
  • Edmond, OK
National Provider Identifier
1447280474
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
HEARTLAND PATHOLOGY CONSULTANTS, PC
Practice address
2701 Coltrane PL Ste 3
Edmond, OK 73034-6783
Phone
(405) 715-4500
Fax
(405) 715-4519
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Rosie J Cheadle
Title
Billing Supervisor
Phone
(405) 705-2644

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

2701 Coltrane PL Ste 3
Edmond, OK 73034-6783

Mailing address

PO Box 26343
Oklahoma City, OK 73126-0343
Phone (405) 705-0018

Other identifiers 1

IdentifierTypeStateIssuer
100746640AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000634 OK Part B Supplier - Independent Clinical Laboratory 6507999455 Practice locations: Edmond, OK

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
37D0936596Heartland Pathology Consultants PC2701 Coltrane Place Suite 3, Edmond, OK 73034AccreditationApr 28, 2028

National Provider Directory

National Provider Directory

Locations

3509 French Park Dr
Ste D
Edmond, OK 73034
Phone (405) 705-2644

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1447280474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26343",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260343",
            "telephone_number": "405-705-0018",
            "fax_number": "405-705-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 COLTRANE PL STE 3",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346783",
            "telephone_number": "405-715-4500",
            "fax_number": "405-715-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND PATHOLOGY CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "CHEADLE",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "405-705-2644"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746640A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.