NPIMap

Organization Active NPI

Ohio Valley Pathologists PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Evansville, IN
National Provider Identifier
1487649398
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
OHIO VALLEY PATHOLOGISTS PC
Practice address
600 Mary St
Evansville, IN 47710-1658
Phone
(812) 450-3344
Fax
(812) 471-6650
NPI assigned
Sep 16, 2005
Last updated
Apr 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Authorized official

Name
Henry W Bockelman, MDNPI 1164417507
Title
President
Phone
(812) 471-1591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZH0000X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

600 Mary St
Evansville, IN 47710-1658

Mailing address

PO Box 3024
Evansville, IN 47730-3024
Phone (812) 471-1591

Other identifiers 1

IdentifierTypeStateIssuer
100247840MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040616001384 IN Part B Supplier - Clinic/Group Practice 3971587973 Receives reassigned benefits from 12 practitioners
Practice locations: Evansville, IN; Newburgh, IN
O20230914002127 KY Part B Supplier - Clinic/Group Practice 3971587973 Receives reassigned benefits from 6 practitioners
Practice locations: Henderson, KY; Morganfield, KY

National Provider Directory

National Provider Directory

Locations

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1487649398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3024",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477303024",
            "telephone_number": "812-471-1591",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101658",
            "telephone_number": "812-450-3344",
            "fax_number": "812-471-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY PATHOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "BOCKELMAN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-471-1591",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247840",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.