NPIMap

Organization Active NPI

Pathology Services, P.C.

  • Clinical Medical Laboratory
  • North Platte, NE
National Provider Identifier
1477548105
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
28D1016662 Issued in NE
Legal business name
PATHOLOGY SERVICES, P.C.
Practice address
1115 S Willow St
North Platte, NE 69101-6082
Phone
(308) 532-4700
Fax
(308) 534-0534
NPI assigned
Sep 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Dianna J Brouillette
Title
General Manager
Phone
(308) 532-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 28D1016662 NE Primary

Addresses

Primary practice location

1115 S Willow St
North Platte, NE 69101-6082

Mailing address

PO Box 1289
North Platte, NE 69103-1289
Phone (308) 532-4700

Other names 1

  • NORTH PLATTE OB CLINIC LAB Doing business as

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
28D1016662North Platte OB Clinic Lab1115 South Willow Street, North Platte, NE 69101Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pathology Services PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1477548105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691031289",
            "telephone_number": "308-532-4700",
            "fax_number": "308-534-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S WILLOW ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016082",
            "telephone_number": "308-532-4700",
            "fax_number": "308-534-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "BROUILLETTE",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "308-532-4700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NE",
            "license": "28D1016662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH PLATTE OB CLINIC LAB",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTH PLATTE OB CLINIC LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.