Organization Active NPI

Physicians Reference Laboratory

  • Anatomic Pathology & Clinical Pathology Physician
  • Leawood, KS
National Provider Identifier
1457507204
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PHYSICIANS REFERENCE LABORATORY
Practice address
3208 W 81St Ter
Leawood, KS 66206-1108
Phone
(913) 338-4070
Fax
(913) 338-4245
NPI assigned
Aug 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Authorized official

Name
Mr. Gregory J Keitges
Title
Coo
Phone
(913) 338-4070

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZB0001X
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X
Dermatopathology (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZD0900X
Neuropathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZN0500X
Molecular Genetic Pathology (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0007X
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary
Clinical Medical Laboratory 291U00000X KS

Addresses

Primary practice location

3208 W 81St Ter
Leawood, KS 66206-1108

Mailing address

7800 W 110TH St
Ste 200
Overland Park, KS 66210-2304
Phone (913) 338-4070

Other identifiers 1

IdentifierTypeStateIssuer
DD4483OtherKSRAILROAD MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1457507204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 W 110TH ST",
            "address_2": "STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102304",
            "telephone_number": "913-338-4070",
            "fax_number": "913-338-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 W 81ST TER",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662061108",
            "telephone_number": "913-338-4070",
            "fax_number": "913-338-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS REFERENCE LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "KEITGES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "913-338-4070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Neuropathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD4483",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.