NPIMap

Organization Active NPI

Merced Pathology Medical Group, Inc.

  • Clinical Medical Laboratory
  • Merced, CA
National Provider Identifier
1609868199
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLF1095 Issued in CA
Legal business name
MERCED PATHOLOGY MEDICAL GROUP, INC.
Practice address
3329 G St
Merced, CA 95340-0964
Phone
(209) 723-4551
Fax
(209) 723-0141
NPI assigned
Aug 19, 2005
Last updated
Jul 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Authorized official

Name
Dr. Grant P Carmichael IV, M.D.NPI 1578555074
Title
President
Phone
(209) 723-4551

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF1095 CA Primary

Addresses

Primary practice location

3329 G St
Merced, CA 95340-0964

Mailing address

3329 G St
Merced, CA 95340-0964
Phone (209) 723-4551

Other identifiers 1

IdentifierTypeStateIssuer
LAB44024FMedicaidCA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3329 G St
Merced, CA 95340
Phone (209) 384-1571

Practitioners & affiliated clinicians

Practitioners 5

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": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1609868199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 G ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-723-4551",
            "fax_number": "209-723-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 G ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-723-4551",
            "fax_number": "209-723-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED PATHOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "CARMICHAEL",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-723-4551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF1095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB44024F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.