NPIMap

Organization Active NPI

Potomac Pathology Consultants Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Martinsburg, WV
National Provider Identifier
1629160858
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
10129 Issued in WV
Legal business name
POTOMAC PATHOLOGY CONSULTANTS INC
Practice address
2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone
(304) 264-1000
NPI assigned
Sep 28, 2006
Last updated
Sep 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Hernando JimenezNPI 1285634113
Title
Owner
Phone
(304) 264-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 10129 WV Primary

Addresses

Primary practice location

2500 Hospital Dr
Martinsburg, WV 25401-3402

Mailing address

PO Box 1295
Bluefield, WV 24701-1295

Other identifiers 2

IdentifierTypeStateIssuer
DG7831OtherWVRAILROAD MEDICARE
0101738000 - IND.MedicaidWV

National Provider Directory

National Provider Directory

Locations

10816 Town Center Blvd
Dunkirk, MD 20754
Phone (741) 885-9903

Practitioners & affiliated clinicians

Practitioners 2

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1629160858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1295",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247011295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254013402",
            "telephone_number": "304-264-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PATHOLOGY CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "HERNANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-264-1212"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WV",
            "license": "10129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG7831",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101738000 - IND.",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.