Organization Active NPI

Florence Pathology Services LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Florence, AL
National Provider Identifier
1558337212
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
00015292 Issued in AL
Legal business name
FLORENCE PATHOLOGY SERVICES LLC
Practice address
1701 Veterans Dr
Florence, AL 35630-4928
Phone
(256) 629-1825
NPI assigned
Feb 23, 2006
Last updated
Mar 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Steven Douglas White, MD
Title
Authorized Official
Phone
(256) 629-1825

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 00015292 AL Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

1701 Veterans Dr
Florence, AL 35630-4928

Mailing address

PO Box 1179
Florence, AL 35631-1179
Phone (256) 629-1825

Other practice location 1

205 Marengo St
Florence, AL 35630-6033
Phone (256) 768-8340

Other identifiers 6

IdentifierTypeStateIssuer
00878878MedicaidMS
4490750MedicaidTN
528601070MedicaidAL
04832896MedicaidMS
051557652MedicaidAL
1369527MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060718000090 AL Part B Supplier - Independent Clinical Laboratory 3476573858 Practice locations: Florence, AL; Moulton, AL; Muscle Shoals, AL; Russellville, AL

National Provider Directory

National Provider Directory

Locations

103 Helton Ct
Florence, AL 35630
Phone (256) 389-8228

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1558337212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1179",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356311179",
            "telephone_number": "256-629-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 VETERANS DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304928",
            "telephone_number": "256-629-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Marengo St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356306033",
            "country_code": "US",
            "telephone_number": "256-768-8340",
            "fax_number": "256-768-9693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORENCE PATHOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "256-629-1825",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "00015292",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00878878",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4490750",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528601070",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04832896",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051557652",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1369527",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.