NPIMap

Organization Active NPI

Pca of Columbia, Inc.

  • Cytopathology Physician
  • Columbia, TN
National Provider Identifier
1497791420
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
2030 Issued in TN
Legal business name
PCA OF COLUMBIA, INC.
Practice address
1602 Hatcher Lane
Columbia, TN 38401
Phone
(931) 490-1000
Fax
(931) 388-1548
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Julie T Andrews
Title
Executive Director
Phone
(931) 388-0777

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X 2030 TN Primary
Dermatopathology (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZD0900X 2030 TN
Immunopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZI0100X 2030 TN
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X 2030 TN
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X 2030 TN
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X 200241 KY

Addresses

Primary practice location

1602 Hatcher Lane
Columbia, TN 38401

Mailing address

1602 Hatcher Lane
Columbia, TN 38401
Phone (931) 388-0777

Other identifiers 7

IdentifierTypeStateIssuer
3403473MedicaidTN
009801160MedicaidAL
1540854MedicaidLA
3790378800MedicaidKY
00789049AMedicaidGA
00119533MedicaidMS
200412900AMedicaidIN

Other names 1

  • PCA Southeast Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080321000207 TN Part B Supplier - Independent Clinical Laboratory 7810970589 Practice locations: Columbia, TN

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
44D0659433Pca Southeast Inc1602 Hatcher Lane, Columbia, TN 38401AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory

Locations

4040 Dutchmans Ln
#A
Louisville, KY 40207
Phone (502) 895-0404

1321 S Locust Ave
Lawrenceburg, TN 38464
Phone (931) 762-9993

719 Thompson Ln
Ste 26300
Nashville, TN 37204
Phone (615) 322-6485

1800 Church St
Ste 109
Nashville, TN 37203
Phone (615) 329-1793

Practitioners & affiliated clinicians

Practitioners 8

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": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1497791420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 HATCHER LANE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "931-388-0777",
            "fax_number": "931-388-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 HATCHER LANE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "931-490-1000",
            "fax_number": "931-388-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCA OF COLUMBIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "931-388-0777"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": "TN",
            "license": "2030",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "TN",
            "license": "2030",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Immunopathology",
            "state": "TN",
            "license": "2030",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TN",
            "license": "2030",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "2030",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "KY",
            "license": "200241",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403473",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009801160",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1540854",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3790378800",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00789049A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119533",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200412900A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCA Southeast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.